Sandra L. Decker (
Health Aff (Millwood). 2018 Jul;37(7):1092-1098. doi: 10.1377/hlthaff.2018.0078.
On average, state Medicaid programs paid 59 percent of what Medicare paid for primary care services in 2012. The Affordable Care Act required states in 2013 and 2014 to raise Medicaid payment rates to primary care physicians for certain services to the level of Medicare rates. The result was an average 73 percent increase in primary care Medicaid payments for qualifying physicians. This study used nationally representative data to examine the association between this Medicaid "fee bump" and physician-reported measures of participation in Medicaid. No such association was found. For example, about 65 percent of primary care physicians reported accepting new Medicaid patients in both 2012 and 2013, whereas about 67 percent reported doing so in 2014-a difference that is not significant. Multivariate results were similar. The lack of a sizable change in measures of physician participation in Medicaid may have been due to the temporary nature of the fee bump.
平均而言，2012 年，各州的医疗补助计划支付的初级保健服务费用仅占医疗保险支付费用的 59%。平价医疗法案要求各州在 2013 年和 2014 年将医疗补助计划向初级保健医生支付某些服务的费用提高到医疗保险的水平。结果是符合条件的医生的初级保健医疗补助支付平均增加了 73%。本研究使用全国代表性数据，考察了这种医疗补助“费用增加”与医生报告的参与医疗补助的措施之间的关联。没有发现这种关联。例如，约 65%的初级保健医生报告说，在 2012 年和 2013 年都接受了新的医疗补助患者，而在 2014 年，约 67%的医生报告说接受了新的医疗补助患者——这一差异并不显著。多变量结果相似。医生参与医疗补助的措施没有出现明显变化，这可能是由于费用增加是临时性的。
