Six States Join Initiative on Finding Ways To Increase Rates for Primary Care Providers

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Medicaid agencies in six states will participate in a new public-private initiative aimed at developing effective strategies to implement a scheduled increase in Medicaid reimbursement rates for primary care providers under the health reform law, the Center for Health Care Strategies (CHCS) announced Aug. 25.

States participating in the initiative will partner with CHCS, a nonprofit policy resource center focused on improving health care quality for low-income Americans, and the Centers for Medicare & Medicaid Services to find ways to leverage the increase in primary care payments. The Commonwealth Fund, a private foundation promoting health care quality, also is supporting the initiative.

The increase in Medicaid reimbursement rates, which will raise the rates for primary care providers up to the rates currently paid under Medicare, is scheduled to begin in 2013 and continue through 2014 under the Patient Protection and Affordable Care Act.

States in the initiative are Colorado, Arkansas, Minnesota, New York, Oregon, and Rhode Island. The states were selected in a competitive application process “based on their capacity to support innovative provider payment reform models,” according to Aliyah Baruchin, communications director for CHCS.

Under PPACA, a major expansion in Medicaid eligibility set to begin in 2014 is expected to add as many as 20 million new enrollees to Medicaid, a low-income health care program funded jointly by the states and the federal government.

In an effort to strengthen the primary care network in advance of this expansion, PPACA provides for an increase in Medicaid reimbursement rates for primary care providers starting in 2013. The new rates will pay primary care providers at parity with Medicare rates, which historically have been higher than Medicaid reimbursement rates.

The initiative will focus on developing “programmatic approaches and technical solutions to the operational challenges of implementing the payment increase,” according to a statement by CHCS.

“With the rate increase, Medicaid agencies have a unique opportunity to lift all boats within their primary care systems, in the more immediate environment and into the future,” said Nikki Highsmith, senior vice president for programs at CHCS. “We are excited to work with this team of states to help them make the most of this opportunity.”