The Medicaid Fee Bump: Increased Reimbursements to Primary Care Providers and Health Care Utilization Among Dual-Eligibles with Chronic Conditions

Project Summary: 

The project team is exploring how the Medicaid primary care fee bump affected the health and costs for beneficiaries with chronic conditions who are covered by both Medicare and Medicaid. The investigators are evaluating whether higher reimbursements to providers for primary care services led to better care and lower overall health care costs for this patient population. The results of the study will provide evidence about whether higher reimbursements to primary care providers are likely to make health care for dual-eligibles more equitable compared to the broader Medicare population.


Health: Ambulatory care sensitive conditions (ACSC)-related hospitalizations, ACSC-related emergency department visits, and readmissions within 30 days.

Other: Total annual health care costs.


This is a natural experiment created by the implementation of the Medicaid fee bump. A difference in differences (DD) approach will be used for estimation. The DD estimate is the adjusted difference in the outcome for dual-eligibles with chronic conditions before and after the Medicare fee bump minus the adjusted difference in the outcome for non-dually-eligible beneficiaries with chronic conditions before and after the fee bump. 

Principal Investigators: 

Hye-Young Jung, PhD

Mark Aaron Unruh, PhD

Grant Start Date: 
August 2016
Award Amount & Duration: 

$279,750 & 18 months