Survey: Most Physicians Favor Medicaid Work Requirements

Survey: Most Physicians Favor Medicaid Work Requirements

By Phillip Miller

Merritt Hawkins

How do physicians feel about a new a new federal policy that allows states to require applicants to work or seek a job in order to obtain Medicaid benefits?

Merritt Hawkins recently sent a one-question survey to physicians nationwide to obtain an answer to this question. It was one in a series of single-question surveys Merritt Hawkins has been sending to physicians regarding various healthcare issues of the day.

Over half (56.6 percent) of physicians responding to the survey said they feel very favorably about the policy, while 17.8 percent indicated they feel somewhat favorably. By contrast, only 9.2 percent of physicians said they feel very unfavorably toward the policy while 8.4 percent said they feel somewhat unfavorably. The remaining eight percent of physicians indicated they feel neither favorably nor unfavorably about the policy.

The survey was conducted by email in early March and was completed by 667 physicians. According to experts in statistical response analysis at the University of Tennessee, the survey has a margin of error (MOE) of <1.0%.

Three states, including Kentucky, Indiana and Arkansas, are proceeding with the work requirements policy. In Kentucky, able-bodied Medicaid applicants 19-64 years old will be required to put in 80 hours of community engagement a month to qualify for Medicaid benefits, working, going to school, training for a job, or volunteering.  The policy in Indiana and Arkansas has similar requirements.

One clear takeaway from the survey that many physicians would like to move away from the Medicaid status quo. Medicaid can be a problematic program for independent physicians who own their own practices, as it often pays less than what it costs physician to provide care.   For employed physicians who may be paid in part on quality, Medicaid also can be a challenge. Many Medicaid patients have complicated health problems that may be caused by societal forces that are beyond a physician’s ability to address.   It is difficult to achieve good outcomes for these patients, and doctors who see poor, more complex patients can be financially penalized for doing so under quality-based payment models.

The new survey contrasts with another single-question survey Merritt Hawkins sent physicians last August, asking doctors where they stand on single-payer.   The majority of physicians responding to that survey indicated they are in favor of single payer.    Combined, the two surveys suggest physicians may not be against government payers in principle, but that many do take issue with Medicaid.

I would be happy to hear what readers think about Medicaid work requirements and the general direction physician and other healthcare payments should take.