A federally mandated increase in Medicaid payments for primary care services appears to have achieved its goal of improving access to care for Medicaid recipients – especially in Pennsylvania.
Doctor listening to patientThe increase, part of the Affordable Care Act, called for raising payments for Medicaid primary care services to the same level as Medicare payments in the hope that such an increase would lead more primary care providers to serve Medicaid patients, thereby improving access to primary care services for those patients.  Historically, primary care providers have been reluctant to serve Medicaid patients, citing low pay as their reason for avoiding such patients.
That Medicaid pay increase – often referred to as the “Medicaid pay bump” – was mandated for two years and expired at the end of 2014.  One of the reasons policy-makers resisted extending it was the lack of proof that it achieved its goal of improving access.  Now, a new study in the New England Journal of Medicine provides the first broad look at the program’s impact – and the first proof of its success.
In the study, researchers selected ten states and measured the availability and waiting times for primary care appointments for two limited periods of time.  They found that

…The availability of primary care appointments in the Medicaid group increased by 7.7 percentage points, from 58.7% to 66.4%, between the two time periods.  The states with the largest increases in availability tended to be those with the largest increases in reimbursements, with an estimated increase of 1.25 percentage points in availability per 10% increase in Medicaid reimbursements.

Among the ten states evaluated in the study was Pennsylvania, where the benefits of the Medicaid pay bump were especially noteworthy:  while the availability of appointments rose eight percent overall in the states that were part of the study, appointment availability rose 13 percent in Pennsylvania.
One possible reason:  the Medicaid pay bump doubled Medicaid primary care fees.
The study’s conclusion?

Our study provides early evidence that increased Medicaid reimbursement to primary care providers, as mandated in the ACA, was associated with improved appointment availability for Medicaid enrollees among participating providers without generating longer waiting times.

Learn more about the study from this Allentown Morning Call article or find the New England Journal of Medicine article here.