Start: August 2011

End: June 2013

Funder: The Commonwealth Fund, with additional support from the New York State Health Foundation and the Massachusetts Medicaid Policy Institute


The increase in Medicaid primary care rates mandated under health care reform offers a potentially powerful tool that states can use to bolster the delivery system and enhance access to and quality of primary care. Increased reimbursement also presents states with critical opportunities to implement advanced primary care payment models, and to align access, quality, and payment standards across Medicaid, its multiple delivery systems, and other public (e.g., the new insurance exchanges) and private payers.

With support from The Commonwealth Fund, the Center for Health Care Strategies (CHCS) developed Leveraging the Medicaid Primary Care Rate Increase to help states use the change in rates to drive improvements in access, quality, and payment reform. CHCS worked with Medicaid agencies and health plans from Arkansas, Colorado, Minnesota, New York, Oregon, Massachusetts, and Rhode Island, along with the Centers for Medicare & Medicaid Services (CMS), on effectively implementing the two-year rate increase. The initiative sought to help these states:

  • Leverage the rate increase to maintain and/or expand the Medicaid PCP network;
  • Efficiently manage technical implementation issues;
  • Capitalize on opportunities to advance payment models and achieve improvements in access to and quality of primary care for beneficiaries; and
  • Assess the impact of the increase and sustain funding beyond 2014.

Through support from the New York State Health Foundation, CHCS also provided additional hands-on technical assistance to New York State to develop a detailed statewide implementation work plan, help the state enhance access to primary care, and identify strategies to sustain the increase beyond 2014.