Do doctors reduce the standard of care when someone is placed on Medicaid? - AgingCare.com

Do doctors reduce the standard of care when someone is placed on Medicaid?

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My mother has been on Medicare since was eligible (she's 73 now) and has in the past 9 months been on Medicaid. I'd like to think that it wouldn't matter, but I can remember my mother stating something to that effect when she worked as the dietary manager in the nursing home.

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While it's true that the payment to doctors and nursing homes under Medicaid is less than if they billed privately, it should not affect the level of care. I have never heard anything to the contrary. As for Medicaid vs Medicare, it should be about the same.
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Here in NYC, there's plenty of ghetto-style, assembly-line care for people on Medicaid. I've seen it, and been through it. The problem is that many people don't realize that white card is their American Express to medical services anywhere in NYS, and initially accept and then get used to seeing the doctor at 3 instead of 9:30. That was never an option for me, so I was labeled the "Monster Patient" b/c I insisted on being treated with respect and being provided with quality services.
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That is an easy one-the answer is yes. This is coming from an R.N. in the field 40+ years. Wish I did not have that as an answer. Can just speak from my experience.
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I think what standards of care you get are interdependent on so many different issues. Some of the best levels of care are in teaching hospital settings and those always take Medicare & Medicaid. But teaching hospitals are almost always in large urban areas so if you live in a more remote rural area you are not going to easily get the same standard of care.
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I am on Medicare and Medicaid, and the quality of my care (I'm 60) has declined drastically since going on it. I am forced to go to a Medicaid clinic even though its my secondary insurance. I am diabetic and get 10 minutes with the doctor every three months. I now go without treatment and diagnoses all the time because there is no time to talk to him about everything that's wrong with me and thus tests do not often get done at all and no treatment. Everyone here in my area knows the truth of this, and they say they wish they could get rid of their Medicaid so that they could get an attentive doctor. So, "expert," you are wrong, I'm sorry to say!
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My Dad who is 90 1/2 has been in a nursing home for going on 3 years and is on Medicaid and Medicare and he is been well taken care of. I am lucky the NH is close by and go often so they know me I think that makes a difference and I thank everyone for taking care of him as I know it is not an easy job. Wishing you all the best.
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I'm not sure a private Dr. would even know that a patient was on Medicaid. For example, I'd be willing to bet that my PCP has no idea what insurance I have.
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Try going to a Medicaid outpatient clinic. They treat you all like second or third class citizens.
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My dad had no changes in care with or without Medicaid in Pittsburgh area. In Arkansas, Little Rock docs are fine with Medicaid, private practice in some towns especially Southwest will not accept it and tend to treat people badly if they have to see them for some reason. YMMV. I sure don't treat Medicaid folks differently, nor do most folks in pediatric practice. Medicaid is stricter about covered prescriptions and tends to pay for only the cheapest in any category, it is a lot of bother to have to fill out forms and write letters and make calls to get something when that is not adequate...repeat q 6 months too. Other than that Medicaid coverage is good coverage for the most part.
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After he developed dementia, my husband had a first-rate geriatrician as primary care physician and a world-famous expert on his form of dementia treating that. I doubt that either of them knew when my husband enrolled in Medicaid. It certainly made no difference in his care. (We are in a large urban area, in Minnesota.)

I think my husband got sub-standard care each time he was hospitalized, both before and after being on Medicaid, and that is because our hospitals -- even great ones -- do a piss-poor job of taking care of those with dementia. It is lamentable, but a completely separate issue from who is doing the paying.

My mother is on Medicaid and is now in a nursing home, and on hospice (paid for by Medicare). I doubt very much if her aides and nurses know how her bills are being paid. I'm impressed with the care she is getting.

My daughter works in an Assisted Living Facility as a PTA. I asked her once how many of their residents are on Medicaid. She said she assumed that most of them who have been there a long time have run out of money and are on Medicaid, but that she doesn't know that for sure or which they are. Obviously she is not giving anybody any worse treatment.

I'm sure it is possible that some places that accept Medicaid are not great places. I suppose that some places that have both private-pay and Medicaid patients do discriminate in the levels of care they provide. I don't doubt the experiences of other posters. But I'm happy to say that I have never seen any of that with my husband or with my mother.
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