title: Medicaid primary care physician fees and the use of preventive services among Medicaid enrollees.
abstract: OBJECTIVE
  The Patient Protection and Affordable Care Act (ACA) increases Medicaid physician fees for preventive care up to Medicare rates for 2013 and 2014. The purpose of this paper was to model the relationship between Medicaid preventive care payment rates and the use of U.S. Preventive Services Task Force (USPSTF)-recommended preventive care use among Medicaid enrollees.
  We used data from the 2003 and 2008 Medical Expenditure Panel Survey (MEPS), a national probability sample of the U.S. civilian, noninstitutionalized population, linked to Kaiser state Medicaid benefits data, including the state Medicaid-to-Medicare physician fee ratio in 2003 and 2008.
  
  
  METHODS
  Probit models were used to estimate the probability that eligible individuals received one of five USPSF-recommended preventive services. A difference-in-difference model was used to separate out the effect of changes in the Medicaid payment rate and other factors.
  
  
  METHODS
  Data were linked using state identifiers.
  
  
  RESULTS
  Although Medicaid enrollees had a lower rate of use of the five preventive services in univariate analysis, neither Medicaid enrollment nor changes in Medicaid payment rates had statistically significant effects on meeting screening recommendations for the five screenings. The results were robust to a number of different sensitivity tests. Individual and state characteristics were significant.
  
  
  CONCLUSIONS
  Our results suggest that although temporary changes in primary care provider payments for preventive services for Medicaid enrollees may have other desirable effects, they are unlikely to substantially increase the use of these selected USPSTF-recommended preventive care services among Medicaid enrollees.
authors.affiliation: Department of Health Systems, Management and Policy, Colorado School of Public Health, Aurora, CO.
authors.forename: Adam
authors.initials: A
authors.lastname: Atherly
authors.forename: Karoline
authors.initials: K
authors.lastname: Mortensen
mesh_terms: D000328:Adult; D000368:Aged; D005249:Fees and Charges / Q000331:legislation & jurisprudence*; D005260:Female; D019538:Health Care Surveys; D006301:Health Services Needs and Demand / Q000191:economics / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008484:Medicaid / Q000191:economics*; D008875:Middle Aged; D058991:Patient Protection and Affordable Care Act; D058007:Physicians, Primary Care / Q000191:economics*; D011322:Primary Prevention / Q000191:economics* / Q000592:standards / Q000706:statistics & numerical data; D014481:United States; D055815:Young Adult
keywords: Medicaid; payment; preventive care