Medicaid physician fees and the use of primary care services: evidence from before and after the ACA fee bump

Anuj Gangopadhyaya (), Robert Kaestner and Cuiping Schiman ()
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Anuj Gangopadhyaya: Loyola University Chicago
Cuiping Schiman: Georgia Southern University

International Journal of Health Economics and Management, 2023, vol. 23, issue 4, No 5, 609-642

Abstract: Abstract We examine whether fees paid by Medicaid for primary care affects the use of health care services among adults with Medicaid coverage who have a high school or less than high school degree. The analysis spans the large changes in Medicaid fees that occurred before and after the ACA-mandated fee increase for primary care services in 2013–2014. We use data from the Behavioral Risk Factors Surveillance System and a difference-in-differences approach to estimate the association between Medicaid fees and whether a person has a personal doctor; a routine check-up or flu shot in the past year; whether a woman had a pap test or a mammogram in the past year; whether a person has ever been diagnosed with asthma, diabetes, cardiovascular diseases, cancer, COPD, arthritis, depression, or kidney diseases; and, whether a person reports good-to-excellent health. Estimates indicate that Medicaid fee increases were associated with small increases in the likelihood of having a personal doctor, or receiving a flu shot, although only having a personal doctor remained significant when accounting for multiple hypothesis testing. We conclude that Medicaid fees did not have a major impact on the use of primary care or on the consequences of that care.

Keywords: Medicaid; Reimbursement; Primary care; Fee-for-service (search for similar items in EconPapers)
JEL-codes: I13 I18 (search for similar items in EconPapers)
Date: 2023
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DOI: 10.1007/s10754-023-09358-9

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