The Affordable Care Act enacted a temporary "Medicaid primary care fee bump" that required states' Medicaid programs to reimburse health care providers the same rates as Medicare for primary care services for all Medicaid patients during a two-year period, 2013-2014. For dual-eligibles, states' Medicaid programs were required to reimburse providers the full 20% Medicare coinsurance for primary care services. Using a difference-in-differences approach with Medicare fee-for-services claims for the period 2011-2014, we sought to answer two questions: (1) Did the Medicaid fee bump improve the quality of care for dual-eligibles with multiple chronic conditions? (2) Did the Medicare fee bump reduce the total costs for dual-eligibles with multiple chronic conditions? The answers to these questions have important implications since only 19 states maintained higher Medicaid payments for primary care services for dual-eligilbes after the fee bump expired at the end of 2014.
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