Government
Medicare & Medicaid: A study in contrasts
■ An occasional snapshot of current facts and trends in medicine.
Quick View. Posted Oct. 15, 2007
Medicaid rates for physician services vary much more widely among states than do Medicare rates.
| Highest Medicaid to Medicare ratios |
|||
|---|---|---|---|
| Medicare | Medicaid | Medicaid as percentage of Medicare | |
| Alaska | $97.41 | $134.86 | 138% |
| Wyoming | $85.61 | $112.23 | 131% |
| Arizona | $92.01 | $96.91 | 105% |
| Delaware | $93.08 | $93.08 | 100% |
| North Carolina | $87.49 | $83.11 | 95.0% |
| Lowest Medicaid to Medicare ratios |
|||
| New Jersey | $101.61 | $25.00 | 25% |
| Pennsylvania | $92.94 | $25.00 | 27% |
| New York | $101.69 | $30.00 | 30% |
| Rhode Island | $93.41 | $29.00 | 31% |
| Washington, D.C. | $104.78 | $48.77 | 47% |
As a result, per-service payments from the two programs come close to matching in some states, while in others doctors are paid much less for their low-income patients than for their elderly patients. The fear is that physicians in low-paying states will stop seeing Medicaid patients. Here is a sampling of what states pay for an initial office visit with a new patient under Medicare and Medicaid. The percentages reflect Medicaid payments in proportion to Medicare payments.
Note: rates for New Jersey, Pennsylvania and New York are average for state's multiple geographic Medicare payment areas
Source: "Equal Pay for Equal Work? Not for Medicaid Doctors," Public Citizen, September
