Project Summary
The project team explored how the Medicaid primary care fee bump affected the health and costs for beneficiaries with chronic conditions who were covered by both Medicare and Medicaid. The team evaluated whether higher reimbursements to providers for primary care services led to better care and lower overall health care costs for this patient population.
Research Question(s)
- Did the Medicaid primary care fee bump decrease ambulatory care sensitive admissions to hospitals and/or emergency department (ED) visits for dual-eligibles with chronic conditions?
- Did the Medicaid primary care fee bump decrease the likelihood of readmission for hospitalized dual-eligibles with chronic conditions?
- Did higher reimbursements to primary care providers resulting from the Medicaid fee bump decrease overall health care costs for dual-eligibles with chronic conditions?
Actionability
- Inform policy-making decisions concerning Medicare reimbursement rates to primary care providers with evidence about whether higher reimbursements rates improve healthcare and lower costs for dual-eligibles compared to the broader Medicare population.
Outcomes
Health: Ambulatory care sensitive conditions (ACSC)-related hospitalizations, ACSC-related emergency department visits, and readmissions within 30 days.
Other: Total annual health care costs.
Methodology
This is a natural experiment created by the implementation of the Medicaid fee bump. A difference in differences (DD) approach will be used for estimation. The DD estimate is the adjusted difference in the outcome for dual-eligibles with chronic conditions before and after the Medicare fee bump minus the adjusted difference in the outcome for non-dually-eligible beneficiaries with chronic conditions before and after the fee bump.
