Medicaid Reimbursements and Access to Primary Care among Children: Evidence from the Medicaid Fee Bump

The Affordable Care Act mandated the Medicaid fee bump, a two-year increase in Medicaid reimbursements for some primary care services in 2013-2014. Research exploring the effect of the fee bump is limited due to data availability. This study used Medicaid claims data in seven states for 2010–14 and included 3,359,135 children aged 0–18 years and continuously enrolled in a plan reimbursing providers on a fee-for-service basis. The estimates showed that $1 increase in state Medicaid reimbursement for vaccine administration, preventive services, and outpatient office services was associated with a 0.42-, 0.19-, and 0.45-percentage-point increase in the probability of having had a vaccination, a preventive visit, and an outpatient office visit in the year, respectively. These numbers translated to an average increase of 14,108 (vaccination), 6,832 (preventive services), and 15,116 (outpatient office services) Medicaid-enrolled children in the sample to utilize the primary care services targeted by the fee bump.