Funder: The Commonwealth Fund

Author: Maia Crawford and Tricia McGinnis, Center for Health Care Strategies

September 2014 | Brief


The Medicaid primary care rate increase, a provision of the Affordable Care Act, requires Medicaid programs to reimburse primary care providers at Medicare levels for two years — a “bump” that is funded 100 percent by the federal government in 2013 and 2014. The increase was intended to ensure sufficient provider participation as the Medicaid population expands. As the temporary provision enters its final months, a number of state and federal policymakers are considering extending the rate increase into 2015 and beyond.

This new Center for Health Care Strategies (CHCS) brief draws from interviews with policy experts and stakeholders across the country to assesses the policy’s successes and shortcomings. The brief examines the rate increase through the provider’s lens, reviews its impact in meeting access and quality goals, and outlines considerations for states interested in extending and strengthening the provision to better meet its goals. It was developed through Leveraging the Medicaid Primary Care Rate Increase, a CHCS initiative made possible by The Commonwealth Fund.