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Restoring Medicaid Payment Bump Would Improve Access to Care

The President’s 2016 budget would reinstate health reform’s temporary boost in Medicaid payments for primary care services and extend it to more providers.  It’s a sound proposal, as new evidence shows the rate increase accomplished its goal of improving access to health care by encouraging providers to accept new Medicaid patients.

Medicaid enrollment has risen significantly since health reform’s coverage expansions took effect in January 2014.  Enrollment now tops 69 million — an increase of more than 10 million since October 2013, according to the Centers for Medicare & Medicaid Services.  To help ensure that both current and newly eligible Medicaid beneficiaries had access to care, health reform required states to boost Medicaid payment rates for certain primary care services to Medicare levels in 2013 and 2014, with the federal government picking up 100 percent of the added cost.

The rate increase worked.  A study recently published in the New England Journal of Medicine looked at appointment availability for new patients among primary care physician offices that participate in Medicaid in ten states.  The authors found that it was easier to obtain an appointment after the higher reimbursements took effect.  They also found that states with the largest increases in reimbursements tended to have the largest increases in appointment availability.

The President’s budget would reinstate the rate bump (which expired at the end of 2014) through 2016 and extend it to more practitioners who provide primary care services, including obstetricians, gynecologists, physician’s assistants, and nurse practitioners.  With more people than ever enrolled in Medicaid and the need for cost-effective Medicaid primary care rising across the country, the higher payment rates would help ensure that primary care providers now participating in Medicaid continue to do so.