The American Academy of Family Physicians reports that there are only six states at this point where primary-care physicians are receiving enhanced Medicaid managed-care payments under the healthcare reform law to bring them up to Medicare payment levels.
The Medicaid payment parity provision of the Patient Protection and Affordable Care Act was designed to promote access to primary care for new Medicaid beneficiaries under the law's expansion of coverage to adults earning up to 138% of the federal poverty level. The pay increase is temporary and covers 2013 and 2014. Though reimbursement varies by state and DRG code, Medicare pays roughly 20% more than Medicaid.
But while the CMS has approved fee-for-service pay-increase plans for every state except California, state medical associations report that a growing number of Medicaid beneficiaries are being cared for under a managed-care plan rather than fee for service. While the AAFP reports that 33 states have had their managed-care pay increases approved by the CMS, that's not the end of the process. States then have to negotiate new prices with managed-care companies.