Medical Billing Blog

Six States and D.C. Extend Medicaid Pay Raise for Primary Care Doctors

Posted by Scott Shatzman on Tue, Aug, 26, 2014 @ 09:08 AM

Color Doctor shortage WEB resized 600Six states and the District of Columbia. will use their own money in 2015 to sustain the federal Medicaid pay raise to primary care doctors. The pay raise stems from a provision of the Affordable Care Act (ACA) that expands Medicaid fees for primary care to the same amount paid under Medicare. The states are Maryland, Colorado, New Mexico, Iowa, Alabama, and Mississippi. Interestingly, Mississippi and Alabama did not participate in the Medicaid expansion under the ACA.

 

The pay raise seeks to attract physicians into Medicaid and make doctors more willing to treat Medicaid patients. The federal enhanced payments go away at the end of 2014. At this time, it does not appear likely that Congress will approve legislation extending the federal contribution for these enhanced payments.

 

While there has been anecdotal information regarding the impact of these enhanced primary care payments in some communities, neither the federal government nor the state governments are collecting any data or attempted to officially study the impact.

 

Alaska and North Dakota paid primary care doctors in Medicaid above the Medicare levels even before the provision took effect in 2013. The remaining 42 states will allow the Medicaid pay rates to revert back to 2012 levels.

 

While Medicaid fees vary by state, the change meant an average 73 percent pay increase nationally, according to a 2012 study by the Kaiser Family Foundation and the Urban Institute.

 

Thanks to Bill Finerfrock, Matt Reiter, Lara Burt, Cassy Perkins and Carolyn Bounds for contributing the article.