Medicaid Physician Fees and Access to Care Among Children with Special Health Care Needs

55 Pages Posted: 24 Feb 2020 Last revised: 23 Aug 2021

See all articles by Pinka Chatterji

Pinka Chatterji

National Bureau of Economic Research (NBER)

Sandra Decker

Government of the United States of America - Agency for Healthcare Research & Quality (AHRQ)

Jason Huh

Rensselaer Polytechnic Institute

Date Written: February 2020

Abstract

The objective of this study is to use data from the National Survey of Children with Special Health Care Needs (NS-CSHCN) to test whether Medicaid physician fees are correlated with access to health services and adequacy of insurance coverage among CSHCN. We use a difference-in-differences method, comparing the effects of Medicaid physician fees on outcomes of publicly-insured children in states that raised fees vs. in states that did not. We also consider a triple difference specification using privately-insured children as the comparison group. Our findings indicate that raising the Medicaid primary care fee level close to at least 90 percent of the Medicare level reduces the likelihood that publicly-insured CSHCN lack a usual source of care in a doctor’s office by about 15 percent. Fee increases are also associated with improved access to specialty doctor care, and large improvements in caregivers’ satisfaction with the adequacy of health insurance coverage, among publicly-insured CSHCN. Results for some other access measures, such as global measures of having difficulties and delays accessing services, were mixed.

Suggested Citation

Chatterji, Pinka and Decker, Sandra and Huh, Jason, Medicaid Physician Fees and Access to Care Among Children with Special Health Care Needs (February 2020). NBER Working Paper No. w26769, Available at SSRN: https://ssrn.com/abstract=3543292

Pinka Chatterji (Contact Author)

National Bureau of Economic Research (NBER) ( email )

1050 Massachusetts Avenue
Cambridge, MA 02138
United States

Sandra Decker

Government of the United States of America - Agency for Healthcare Research & Quality (AHRQ) ( email )

540 Gaither Road, Suite 2000
Rockville, MD 20850
United States

Jason Huh

Rensselaer Polytechnic Institute ( email )

110 8th Street
Troy, NY 12180
United States

HOME PAGE: http://www.jason-huh.com

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