Medicaid Physician Fees, Use of Preventive Care, and the 2013-2014 ACA Medicaid Fee Bump
Medicaid has historically paid much lower rates for physician care compared to other payers. For example, in 2012 the average ratio of Medicaid physician fees relative to Medicare for a basket of primary care services was 59% (Zuckerman and Goin, Kaiser Family Foundation, 2012). The first paper in this session examines the relationship between past Medicaid physician fees and the use of breast and cervical cancer screening using claims data from the Medicaid Analytic eXtract (MAX), an underused resource in Medicaid research. The ACA mandated that Medicaid fees for some primary care services and providers be increased to Medicare rates in 2013-2014. Because this mandate did not apply to all services or providers and because of uncertainty about whether this mandate filtered through to managed care providers, the second paper compares data on payments per visit in 2013 to payments for prior years to gauge the magnitude of the effect of the Medicaid fee bump on physician revenue. The final paper in the session is the first to use nationally-representative data to examine the effects of the Medicaid fee bump on physician and patient outcomes. Specifically, the paper examines the effect on physician participation in Medicaid using data from a 2011-2014 nationally-representative survey of physicians, and the effect on measures of access to health care using the 2011-2014 National Health Interview Survey.