I don't know about medicare, but I do take medicaid. Right now I take anything bec. I'm new, but eventually I will cut back to the better paying insurances. The problem is that medicaid reimbursement is so low! For one patient I saw I got 26 dollars. Right now, that's $26 that I didn't have. Imagine, however, if I had a busy practice and not enough time slots and I could fill that space with someone whose insurance will pay $55 for the same service. It is nice to think altruistically that I should take everyone, but realistically I have bills to pay and a limited amount of time.
Most of the people in my area are on medicaid HMOs, so I don't have the option of cutting out medicaid altogether, but I will have to cut out the lower paying ones eventually.
I always work in rural areas- some are RURAL HEALTH CLINICS (ie federally designated) some are not...but they all take both MEDICARE and MEDICAID...we would have to given our population.
That being said LONG hours of talk and thought go into HOW CAN WE MAKE MORE PROFIT bc those two entities are KILLING us-
so we dream up higher paying procedures, docs don't get raises, we don't get new equipment, etc etc.
I take Medicare but not Medicaid. The reason for taking Medicare as a psychiatrist is it's a relatively small proportion of my practice, some interesting patients with severe mental illnesses, and they pay on time even if they don't pay that well. Medicaid in my state is extremely low-paying and high maintenance managed care. Medicare is not managed for psychiatry which means less paperwork than my patients with insurance. They pay just over half of my billable fee ...