Medicare & Medicaid: A study in contrasts
Quick View. 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
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Copyright 2007 American Medical Association. All rights reserved.
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