Capitated Medicaid managed-care plans in Massachusetts paid more to hospitals and doctors than the state's rate-regulated Medicaid fee-for-service plan, a newly released report said.
The Massachusetts inspector general called the average payment by a capitated plan “substantially higher” than that of fee-for-service Medicaid for the year that ended Sept. 30, 2011. For patients who were admitted to the hospital, the difference was 28%, or $133 million more, according to the report (PDF), which was mandated by the state's legislature. For outpatient services, capitated plans paid 38% higher, on average, or $142 million more. Capitated plan payments exceeded fee-for-service professional services payments by 33%, or $73 million more.