{"id":170176,"date":"2026-02-09T09:37:09","date_gmt":"2026-02-09T09:37:09","guid":{"rendered":"https:\/\/www.newsbeep.com\/us-ca\/170176\/"},"modified":"2026-02-09T09:37:09","modified_gmt":"2026-02-09T09:37:09","slug":"ghost-medicaid-doctors-leave-patients-in-the-waiting-room","status":"publish","type":"post","link":"https:\/\/www.newsbeep.com\/us-ca\/170176\/","title":{"rendered":"\u2018Ghost\u2019 Medicaid Doctors Leave Patients in the Waiting Room"},"content":{"rendered":"

By\u00a0Jennifer Porter Gore<\/a><\/p>\n

Overview: While Medicaid covers roughly 96 million Americans, research findings indicate that many of the predominantly low-income, disabled, and young enrollees have a hard time actually getting treatment. This includes the millions of Black Americans who get their healthcare through the program.<\/p>\n

(WIB) \u2013 Roughly 1 in 3 doctors who are enrolled to treat Medicaid patients didn\u2019t treat a single one between 2019 and 2021, according to new research published\u00a0Tuesday.<\/a>\u00a0<\/p>\n

At the opposite end of the spectrum,\u00a0 a third of enrolled health care providers saw more than 150 Medicaid patients each year, a workload experts say may be stretching\u00a0 them too thinly. The doctors\u2019 care load varied widely depending on their specialty and geographical location. A median of Cardiologists saw 81 Medicaid patients each year but primary care physicians treated 51 patients. However, the median for psychiatrists was just three Medicaid patients for the entire year.\u00a0<\/p>\n

The vast disparity between so-called \u201cghost\u201d doctors with untreated Medicaid patients and doctors who treat far more Medicaid patients than most primary care physicians is more than a statistical mismatch. It means that the millions of predominantly low-income, disabled, and young enrollees\u2019 health care access depend on a relatively small cadre of clinicians who accept Medicaid patients consistently.\u00a0<\/p>\n

Medicaid Doctors In Name Only<\/p>\n

And while the system appears robust on paper, covering roughly\u00a096 million Americans<\/a>, the findings \u2014 reported in Health Affairs, an online journal \u2014 indicate the healthcare system for low-income people is far more fragile in practice.<\/p>\n

That\u2019s a warning sign for Black Americans, who make up just over 21.4% of adult Medicaid beneficiaries ages 19 to 64. Almost 22% of children covered by Medicaid or the Children\u2019s Health Insurance Program are Black, and Medicaid covers\u00a0more than half of sickle cell<\/a>\u00a0disease patients nationwide.\u00a0<\/p>\n

Dr.\u00a0Jane Zhu<\/a>\u00a0of Oregon Health & Science University, the study\u2019s lead author, says that having a healthcare system that relies on a relatively small number of doctors to provide most of the care creates a problem that needs urgent attention.\u00a0<\/p>\n

\u201cLow physician participation in Medicaid is a commonly cited reason for access gaps and unmet need in Medicaid,\u201d she says. \u2018If patients aren\u2019t able to access the care they need, they may delay or forego care altogether, which is not only bad for patient outcomes but also bad for the health system overall.\u201d<\/p>\n

Researchers examined the most recent available Medicaid claims data. They analyzed administrative claims and provider enrollment data for primary care doctors and specialists in cardiology, dermatology, ophthalmology, and psychiatry.<\/p>\n

The gap was especially pronounced in psychiatry: more than 40% of psychiatrists enrolled in Medicaid during that period didn\u2019t treat any Medicaid patients.\u00a0\u00a0<\/p>\n

Also, federal data shows doctors have been\u00a0less likely to accept<\/a>\u00a0new Medicaid patients than new patients covered by Medicare \u2014 the government health plan for seniors \u2014 or privately insured patients. Separate data show that fewer than half of psychiatrists and dermatologists accepted new Medicaid patients, while just over 60% of internal medicine specialists did.\u00a0<\/p>\n

The situation worsens for low-income patients who need dental work, as only\u00a01 in 3 dentists<\/a>\u00a0reported treating Medicaid patients.\u00a0<\/p>\n

Zhu said the lack of access increases the risk of poor health outcomes, which ultimately raises costs and worsens outcomes. Over the long term, she said, delaying or foregoing care can\u00a0leave people sicker with more complex conditions that\u00a0ultimately\u00a0increase\u00a0costs.\u00a0<\/p>\n

Limited Access Likely to be Even More Restricted<\/p>\n

Separate research has found a racial element to the situation: Black beneficiaries were\u00a0less likely than white\u00a0adult Medicaid beneficiaries to report\u00a0having\u00a0primary care visits\u00a0<\/a>and\u00a0mental health care\u00a0in the previous 12 months.\u00a0<\/p>\n

To treat Medicaid patients, physicians must enroll in their state\u2019s program, meet licensing and credentialing requirements, and sign participation agreements to bill Medicaid. While the doctors gain access to a large pool of patients and steady reimbursement, they aren\u2019t required to see a minimum number of Medicaid patients \u2014 or any at all.<\/p>\n

In some cases, Zhu said, providers may be technically enrolled in Medicaid as part of their health system\u2019s contracting or employment requirements. Or they have enrolled despite their clinical schedule being at capacity with patients covered by commercial insurance.<\/p>\n

Created as part of President Lyndon B. Johnson\u2019s Great Society program, Medicaid fills critical healthcare gaps for low-income people. For example, it covers more than 40% of births in the U.S., including more than half in Louisiana, Mississippi, New Mexico, and Oklahoma. It also pays out-of-pocket health costs for low-income retired Medicare recipients and provides nursing home and in-home care\u00a0services for the elderly.<\/a>\u00a0<\/p>\n

The Trump administration\u2019s \u201cOne Big, Beautiful Bill Act\u201d will cut Medicaid expenditures by almost $1 trillion. Experts say the cuts will force roughly 10 million Americans to lose their coverage.<\/p>\n

\u201cMaintaining access to care is a really big problem with increasing demand for services and workforce shortages,\u201d Zhu said. \u201cA clearer picture would help policymakers better spend public dollars on levers that meaningfully impact provider participation.\u201d<\/p>\n

Either way, she said it\u2019s important for policymakers to assess the actual experience of patients who can\u2019t get access to a health care provider \u2014 rather than relying on enrollment figures that may not reflect reality.\u00a0<\/p>\n

RELATED:\u00a0GOP Bill Is a Win for Some\u2014But a Crisis for Black People<\/a><\/p>\n

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