Associations Between the Patient Protection and Affordable Care Act Medicaid Primary Care Payment Increase and Physician Participation in Medicaid

JAMA Internal Medicine
Andrew W MulcahyKenneth Finegold

Abstract

The Patient Protection and Affordable Care Act (ACA) increased 2013 to 2014 Medicaid payment rates for qualifying primary care physicians (PCPs) and services to higher Medicare payment levels, with the goal of improving primary care access for Medicaid enrollees. To evaluate the payment increase policy and to assess whether it was associated with changes in Medicaid participation rates or Medicaid service volume among PCPs. This study used 2012 to 2015 IMS Health aggregated medical claims and encounter data from PCPs eligible for the payment increase practicing in all states except Alaska and Hawaii and included 20 723 PCPs with observations in each month from January 1, 2012, to December 31, 2015. Data are for professional services performed in ambulatory settings, including office, hospital outpatient department, and emergency department. Regression models were used to test whether outcomes differed in months subject to higher payment rates relative to months before the increase and after the expiration of the increase in some states. The models controlled for time-invariant physician characteristics and time-varying characteristics, such as Medicaid enrollment. Interaction terms were included to estimate differential associa...Continue Reading

References

Feb 22, 2012·Medicare & Medicaid Research Review·Anna S SommersCarolyn Miller
Jan 26, 2013·Health Services Research·Carole Roan GresenzFabian Duarte
Apr 9, 2014·JAMA Internal Medicine·Karin V RhodesDaniel Polsky
Jan 22, 2015·The New England Journal of Medicine·Daniel PolskyKarin V Rhodes
Jun 25, 2015·Journal of General Internal Medicine·Catherine M DesRochesEugene C Rich
Nov 14, 2017·JAMA Internal Medicine·Molly CandonDaniel Polsky

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Citations

Oct 17, 2019·Forum for Health Economics & Policy·Jiajia ChenRobert Kaestner
Sep 12, 2019·International Journal of Health Economics and Management·Naomi Zewde
Nov 16, 2019·International Journal of Health Economics and Management·Xiaoxue Li
Jan 6, 2021·Health Affairs·Steven B SpivackValerie A Lewis
Dec 14, 2021·Health Services Research·Vilsa Curto, Monica Bhole

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