In my state people used to go on and off Medicaid month to month and then I might have a handful every month. Now, there is a place on the Medicaid application to check a box and enter your annual income, and that has significantly reduced flux. Before, someone might lose Medicaid on a 3-paycheck-month (if they are paid every 2 weeks) but otherwise qualify for it.
Yes. I see mostly young families so oftentimes they will be on Medicaid if Mom's off work due to pregnancy complications or while the family business is growing or if a parent loses a job or something. I have some who are chronically on Medicaid but I'm pretty close to my patients and I don't mind.
Mine seems to stay really stable. Since I only accept new patients for DPC, I seem to have even numbers with their situation improving and their situation worsening. So my total numbers are stable but my percentage of Medicaid is dropping (since I'm still accepting new DPC). I truly believe that good primary care helps people improve their situation and get off Medicaid because getting treatment for what ails (including physical and mental health problems) allows people to move on with their lives
At least in my state, I can opt to be "open" or "closed". I keep my practice "closed" but I can still add as many new patients as I want, I just don't get the $2 PMPM primary care medical home fee on those patients. I can reopen once in awhile, add all those patients that have gotten on Medicaid in between times, and then close again...but I haven't done that because it's not worth it to me. A lot of this depends on having someone sympathetic. I go way back with a woman who is an administrator with my regional care collaborative for Medicaid so if I'm having a problem, I just email her. Unfair, but it helps.