Raising Medicaid Primary Care Rates: Next Steps for States

The Department of Health and Human Services (HHS) recently released long-awaited proposed regulations for implementing the Affordable Care Act's Medicaid primary care rate increase. Reimbursement rates for all types of health care services provided to Medicaid beneficiaries have historically lagged behind fees paid to providers treating Medicare beneficiaries or people with private insurance. But in 2013 and 2014, Medicaid primary care providers will be reimbursed by states on par with Medicare rates for certain services, with the federal government picking up the cost of the increase.

In a new blog post, Tricia McGinnis of the Center for Health Care Strategies offers takeaways from the proposed rule, the guidance states will require to carry out the change, and suggestions for implementation, including exploring strategies for confirming primary care provider eligibility.