Medicaid Primary Care Physician Fees and the Use of Preventive Services among Medicaid Enrollees |
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Authors: | Adam Atherly Karoline Mortensen |
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Affiliation: | 1. Department ofHealth Systems, Management and Policy, Colorado School of Public Health, , Aurora, CO;2. Department of Health ServicesAdministration, University of Maryland, 3310 School of Public Health Building, , College Park, MD 20742-2611 |
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Abstract: | ObjectiveThe Patient Protection and Affordable Care Act (ACA) increases Medicaid physician fees for preventive care up to Medicare rates for 2013 and 2014. The purpose of this paper was to model the relationship between Medicaid preventive care payment rates and the use of U.S. Preventive Services Task Force (USPSTF)–recommended preventive care use among Medicaid enrollees.Data Sources/Study SessionWe used data from the 2003 and 2008 Medical Expenditure Panel Survey (MEPS), a national probability sample of the U.S. civilian, noninstitutionalized population, linked to Kaiser state Medicaid benefits data, including the state Medicaid-to-Medicare physician fee ratio in 2003 and 2008.Study DesignProbit models were used to estimate the probability that eligible individuals received one of five USPSF-recommended preventive services. A difference-in-difference model was used to separate out the effect of changes in the Medicaid payment rate and other factors.Data Collection/Extraction MethodsData were linked using state identifiers.Principal FindingsAlthough Medicaid enrollees had a lower rate of use of the five preventive services in univariate analysis, neither Medicaid enrollment nor changes in Medicaid payment rates had statistically significant effects on meeting screening recommendations for the five screenings. The results were robust to a number of different sensitivity tests. Individual and state characteristics were significant.ConclusionsOur results suggest that although temporary changes in primary care provider payments for preventive services for Medicaid enrollees may have other desirable effects, they are unlikely to substantially increase the use of these selected USPSTF-recommended preventive care services among Medicaid enrollees. |
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Keywords: | Medicaid payment preventive care |
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