Noteworthy News

Medicaid Primary Care Fee Increases: How Much?

The Affordable Care Act requires state Medicaid programs to raise primary care provider fees to Medicare levels in calendar years 2013 and 2014.  The purpose of the rate increase is to improve access to Medicaid services at a time when the program will be adding millions to its rolls across the country.

But how much will those primary care fees actually rise?

According to a survey conducted by the Urban Institute for the Kaiser Commission on Medicaid and the Uninsured, Medicaid primary care fees currently average 66 percent of Medicare fees and currently range from  58 percent of the national Medicaid average in Rhode Island to 242 percent of the national average in Alaska.  The gap between Medicare and Medicaid primary care fees has been growing in recent years, so the two-year policy change will raise the average Medicaid primary care fee 73 percent in 2013.

Because they serve so many Medicaid patients, urban safety-net hospitals that own physician practices could benefit considerably from this temporary increase in Medicaid primary care fees.

The Urban Institute survey includes a 50-state survey that also examines current fees for a wide variety of services and shows how they vary from state to state.  Find a report on the survey’s findings hereinternal_masthead_kcmu,jpg, on the web site of the Kaiser Commission on Medicaid and the Uninsured.

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