Emails, Steve Levine, vice president of Communication, Texas Medical Association, March 24 and April 5, 2017

8:25 a.m.

Below is the data we have from the past three surveys, all with nearly identical methodology as you reported in 2013 about our 2012 survey. As I mentioned yesterday, I know of no other source for this kind of data. HHSC can likely give numbers of how many Texas docs are enrolled to take Medicaid patients and how many may have billed for service at least once in the past year (as you reported in 2013), but no one else uses as comprehensive an approach as we do.

Let me know if you need additional information.

Steve

Texas Physicians Who Accept All New Medicaid Patients

The question has been asked the same way regularly in our biennial physician surveys: "For patients covered by the following payers, does your practice currently (1) accept all new patients, (2) limit new patients that you will accept, or (3) accept no new patients?"

Results from the past three surveys:

Comment from our 2014 survey: Inadequate Medicaid payments have damaged access to care for Medicaid patients, which remains significantly reduced from the 67 percent who accepted all new Medicaid patients in 2000. However, a five percent increase in the percentage of physicians who will accept all new Medicaid patients could be the result of federally required temporary payment increases to Primary Care physicians.

Comment from our 2016 survey: The federally required payment increases to primary care physicians continued to have a positive effect on the percentage of physicians accepting all new Medicaid patients, despite those payment increases being temporary.

From: Selby, Gardner (CMG-Austin)

Sent: Friday, March 24, 2017 10:24 AM

Subject: RE: Queries for a fact check

Thanks. Can you provide the original 2016 survey with margins of error and such (number of individuals polled etc.)?

ALSO: At a glance, it looks like about 6 in 10 physicians don’t accept all or 4 in 10 don’t accept any. That a fair read?

Either way, why the changes over a few years?

g.

2:04 p.m.

The question is exactly as I stated it below: "For patients covered by the following payers, does your practice currently (1) accept all new patients, (2) limit new patients that you will accept, or (3) accept no new patients?"

Margin of error for both years is plus or minus 5%

2014  n=885

2016  n=1,065

I think your interpretation is correct.

Reason for the change, we believe, is that the Affordable Care Act included a provision where the feds paid the states, for two years only, to increase Medicaid payment rates to primary care physicians providing certain primary care services at the same rate as Medicare. Without that increase, which expired at the end of 2014, Medicaid payments for those services are about 60-80 percent of Medicare rates. That’s what I was trying to say in the highlighted sentences in the comments below the table. (Here’s some more background: https://www.texmed.org/Template.aspx?id=26037)

From: Selby, Gardner (CMG-Austin)

Sent: Wednesday, April 05, 2017 4:27 PM

To: Steve Levine

Subject: FW: ?

Phil Miller below makes an interesting point; new to me. Thoughts for our story?

I had shared with Miller the HHSC spreadsheet I shared with you the other day. You’d stressed, in our phone visit Tuesday, the ratio of physicians who had a Medicaid claim paid in 2016 versus all physicians licensed to practice in Texas. He suggests a tighter analysis.

?

g.

From: Phil Miller

Sent: Wednesday, April 05, 2017 3:29 PM

To: Selby, Gardner (CMG-Austin)

Subject: RE: Austin reporter

These numbers show physicians licensed in Texas at 74,000, but the relevant point is the number who are in active patient care, which is about 51,000 in 2016:

http://www.dshs.texas.gov/chs/hprc/tables/2016/16DPC.aspx

 If some 32,000 Texas physicians were paid on Medicaid claims last year, this suggests that at least 63% of active Texas physicians saw Medicaid patients.          

Phillip Miller

Vice President, Communications

Merritt Hawkins and Staff Care

(Levine)

4:31 p.m.

April 5, 2017

Still – having one Medicaid claim paid is not nearly the same as taking new (let alone all new) Medicaid patients.