Expired Medicaid Payment Bump Had Increased New Patient Appointment Availability

Daniel Polsky PhD Executive Director, Leonard Davis Institute of Health Economics Professor of Medicine and Health Care Management Perelman School of Medicine and the Wharton School University of PennsylvaniaMedicalResearch.com Interview with:
Daniel Polsky PhD
Executive Director, Leonard Davis Institute of Health Economics
Professor of Medicine and Health Care Management
Perelman School of Medicine and the Wharton School
University of Pennsylvania

Medical Research: What is the background for this study? What are the main findings?

Dr. Polsky: The Medicaid Fee bump, a provision of the Affordable Care Act (ACA), raised Medicaid payments to Medicare levels in 2013 and 2014 for selected services and providers expired on January 1, 2015 before policymakers had much empirical evidence about its effects.   The federally funded increase in reimbursements was aimed at expanding access to primary care for the growing number of Medicaid enrollees. The reimbursement increase expired at the end of 2014 in most states.  We found that this policy worked to increase the number of providers offering primary care appointments to Medicaid patients.  The Medicaid pay bump was associated with a 7.7 percentage points increase in new patient appointment availability without longer wait times.   This increase in availability was largest in the states where primary care physicians received the largest increase in their Medicaid reimbursements.

Medical Research: What should clinicians and patients take away from your report?

Dr. Polsky: Physician participation in Medicaid is largely a function of reimbursement levels.  When levels are increased from the low levels that have existed in many states, physicians are more likely to participate.

Medical Research: What recommendations do you have for future research as a result of this study?

Dr. Polsky: We focused on behavior of practices that already participate in the Medicaid program.  We did not study whether the policy increased the number of newly participating Medicaid providers.  This would be an important area of future research.

Citation:

Appointment Availability after Increases in Medicaid Payments for Primary Care

Daniel Polsky, Ph.D., Michael Richards, M.D., Ph.D., Simon Basseyn, B.A., Douglas Wissoker, Ph.D., Genevieve M. Kenney, Ph.D., Stephen Zuckerman, Ph.D., and Karin V. Rhodes, M.D.
This article was published on January 21, 2015, at NEJM.org
DOI: 10.1056/NEJMsa1413299

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