The authors examined the National Surveys of America's Families for years 1997, 1999, and 2002 and the Urban Institute Medicaid capitation rate surveys. The authors conclude that states that are able and willing to set higher payment rates can enhance Medicaid for their beneficiaries and increase its attractiveness to potential employees. However, given the limited impact of rates on access and use, modest pay cuts may also be an option that will not adversely affect users when state budgets tighten. Fees can be reduced by five to ten percent without serious, negative results. "In all cases where we detected significant payment effects, we found that higher rates improved access and use for Medicaid beneficiaries," state the authors.
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Stephen Zuckerman is a principal research associate in the Health Policy Center at the Urban Institute. During his twenty years as a health economist, he has studied issues related to physician payment, hospital rate setting, insurance coverage and market reforms, the health care safety net, and medical malpractice.
Dr. Zuckerman is available for questions and interviews.
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