Abstract

On average, state Medicaid programs paid 59percent of what Medicare paid for primary care services in 2012. The Affordable Care Act required states in 2013 and 2014 to raise Medicaid payment rates to primary care physicians for certain services to the level of Medicare rates. The result was an average73percent increase in primary care Medicaid payments for qualifying physicians. This study used nationally representative data to examine the association between this Medicaid "fee bump" and physician-reported measures of participation in Medicaid. No such association was found. For example, about 65percent of primary care physicians reported accepting new Medicaid patients in both 2012 and 2013, whereas about 67percent reported doing so in 2014-a difference that is not significant. Multivariate results were similar. The lack of a sizable change in measures of physician participation in Medicaid may have been due to the temporary nature of the fee bump.

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