Medicaid Primary Care Pay: The Next SGR?

Reid Blackwelder, MD, a family physician in Kingsport, Tenn., said primary care physicians in his state would benefit immensely from a federal proposal raising Medicaid payments to equal what Medicare pays for the same services.

TennCare, the state’s Medicaid program, currently pays him only 60% of Medicare rates, Dr. Blackwelder said. If TennCare had paid 100% of Medicare rates for the previous 10 months of billing, from July 2011 through April 2012, “we would have made an additional $400,000 in our three residency programs,” said Dr. Blackwelder, a professor of family medicine at East Tennessee State University Quillen College of Medicine. Medicaid beneficiaries make up nearly 40% of the residency programs’ patient base.

Read the full story: