Medicaid is a program headed by the federal government and which is administered by individual states. It is designed with the specific purpose of helping low-income families and individuals with health-related costs. It should come as no surprise that such a large social initiative as Medicaid has both pros and cons. Hopefully this article can make things a little clearer, for both patients and providers of care.
Access to Care
The most important, straight forward and obvious advantage for patients is the access to care that Medicaid provides. Medicaid provides access to people who would not otherwise be able to afford it. Simply put, take away Medicaid and you take away that access. The impact of losing Medicaid would be horrendous. Scores of low-income individuals and families would simply not be able to afford medical care and so would be left without basic and specialized care. For an example of this in action, the American Student Dental Association has said that it is Medicaid that covers most necessary dental and medical expenses.
Reliable Income for Practitioners
Those practitioners who choose to go ahead and accept Medicaid have their payment guaranteed by the government. Different states can offer lucrative contacts plus other incentives to increase the number of practitioners who participate in the program. These payments and incentives can make up a large part of their income, plus there is minimal risk of non-payment or expenses related to the collection of overdue bills. Increased numbers of practitioners accepting Medicaid is a win win for all concerned and should be greatly encouraged.
A Steady Flow Of Customers For Practitioners
It stands to reason that for those medical and dental practices that choose to play a part in the Medicaid program, they will end up serving an extremely large pool of patients. They can rely and count on this constant stream of customers and be confident in receiving what will be a steady and long-term source of income. In addition, they do not have to spend money on advertising, nor do they have to seek patients, as Medicaid beneficiaries are provided with a list of participating practitioners.
Extent Of Medicaid Coverage
It is not a given that Medicaid will cover all treatments and procedures – there are circumstances for example in which the program could deem certain treatments unnecessary or even in some cases too experimental. Where there are disagreements, things can become complicated and drawn out, with lots of back and forth between a physician or patient with Medicaid administrators in an attempt to verify the need of a procedure. If Medicaid ultimately decides not to cover the expense of a certain procedure, there is very little that can be done.
Yes, as already noted, whilst Medicaid practitioners can rely on a steady flow of business, the money they receive for this, although guaranteed, can often be lower than what they would normally charge. Whilst this does help to keep overall costs down for the program, as you can imagine it can end up discouraging doctors from readily accepting Medicaid patients. There is also the inconvenience that arises from the fact that payment can take between 37 and 155 days to clear, which can be much too long for those smaller practices that have to rely on access to cash quickly to pay their expenses.