Appointment availability after increases in Medicaid payments for primary care

Area of Science:

• Health Services Research
• Health Policy
• Primary Care Access

Background:

• The Affordable Care Act (ACA) increased Medicaid reimbursements to Medicare levels for primary care services.
• This policy aimed to improve access for a growing number of Medicaid enrollees.
• The reimbursement increase expired before comprehensive data on its effects were available.

Purpose of the Study:

• To evaluate the impact of increased Medicaid reimbursements on primary care appointment availability and waiting times.
• To assess the relationship between the magnitude of reimbursement increases and changes in appointment availability.

Main Methods:

• A study was conducted in 10 states, comparing appointment availability and waiting times for Medicaid and privately insured patients.
• Trained field staff posed as patients seeking new primary care appointments during two periods: pre-increase (2012-2013) and post-increase (2014).
• Analysis focused on primary care practices participating in Medicaid to link reimbursement changes with appointment availability.

Main Results:

• Primary care appointment availability for Medicaid enrollees increased by 7.7 percentage points (from 58.7% to 66.4%).
• States with larger reimbursement increases showed greater improvements in appointment availability.
• No significant changes in waiting times were observed for either Medicaid or privately insured patients.

Conclusions:

• Increased Medicaid reimbursement rates were associated with improved primary care appointment availability for Medicaid enrollees.
• The policy change enhanced access without negatively impacting appointment wait times.
• This provides early empirical evidence supporting the ACA's impact on primary care access.