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The Effects of Changes in Medicaid Physician Fees on the Use of Preventative Care

Faculty Associate Karoline Mortensen to model effects of Affordable Care Act on Medicaid enrollees

The purpose of this project, an R21 grant from NICHD, is to model the effects of the Patient Protection and Affordable Care Act of 2010 (PPACA) on the use of U.S. Preventive Services Task Force (USPSTF)-recommended preventive care among Medicaid enrollees. PPACA makes several changes to Medicaid rules designed to increase the use of preventive care. First, it alters the financial incentives for primary care physicians receiving Medicaid reimbursement for preventive services. Second, it includes a one percentage point Federal Medical Assistance Percentage (FMAP) incentive to states that cover preventive care benefits and prohibit Medicaid preventive care cost sharing that had been allowed previously.  Finally, PPACA expands eligibility for Medicaid to previously ineligible populations. This study will model the impact of these variations in Medicaid rules on the use of USPSTF-recommended preventive care and project the effect of the changes mandated by PPACA. Then, the effects of the elimination of the physician fee changes in 2015 will be estimated, along with the cost of increased use of these preventive services. Dr. Mortensen will use data from the Medical Expenditure Panel Survey (MEPS), the National Ambulatory Medical Care Survey (NAMCS) and the Safety Net Monitoring Initiative. Econometric techniques including fixed effects and difference-differences analyses will control for the endogeneity of Medicaid variables.

Karoline Mortensen is an Assistant Professor in the Department of Health Services Administration, School of Public Health, at the University of Maryland, College Park. She is also affiliated with Academy Health, the American Society of Health Economics, the Association for Public Policy Analysis and Management, the International Health Economics Association, and the University of Maryland Prevention Research Center.

See Karoline Mortensen's profile