Reimbursement Rates for Primary Care Services: Evidence of Spillover Effects to Behavioral Health

56 Pages Posted: 16 Jul 2018

See all articles by Catherine Maclean

Catherine Maclean

Temple University

Chandler McClellan

American University - School of Public Affairs

Michael Pesko

Georgia State University - Department of Economics

Daniel Polsky

Bloomberg School of Public Health, Department of Health Policy and Management, Johns Hopkins University; Johns Hopkins University - Carey Business School

Date Written: July 2018

Abstract

We study spillover effects from the largest increase in Medicaid reimbursement rates in the history of the program for primary care services to behavioral health and healthcare outcomes; mental illness, substance use disorders, and tobacco product use. Much of the variation in Medicaid reimbursement rates we leverage is attributable to a large federally mandated increase between 2013 and 2014. We apply differences-in-differences models to survey data specifically designed to measure behavioral health outcomes over the period 2010 to 2016. We find that higher primary care Medicaid reimbursement rates improve behavioral health outcomes among enrollees. We find no evidence that behavioral healthcare service use is altered. Previous economic research shows that the mandated boost increased office visits. Thus our results suggest that primary care providers are efficient in improving behavioral health outcomes among Medicaid enrollees. Given established shortages of behavioral health providers, these findings are important from a healthcare workforce and policy perspective.

Suggested Citation

Maclean, Catherine and McClellan, Chandler and Pesko, Michael and Polsky, Daniel, Reimbursement Rates for Primary Care Services: Evidence of Spillover Effects to Behavioral Health (July 2018). NBER Working Paper No. w24805. Available at SSRN: https://ssrn.com/abstract=3214349

Catherine Maclean (Contact Author)

Temple University ( email )

Philadelphia, PA 19122
United States

Chandler McClellan

American University - School of Public Affairs ( email )

Washington, DC 20016
United States

Michael Pesko

Georgia State University - Department of Economics ( email )

P.O. Box 3992
Atlanta, GA 30302-3992
United States

Daniel Polsky

Bloomberg School of Public Health, Department of Health Policy and Management, Johns Hopkins University ( email )

624 North Broadway
Baltimore, MD 21205
United States

Johns Hopkins University - Carey Business School ( email )

100 International Drive
Baltimore, MD 21202
United States

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