“The payment increase had at best, a modest effect on provider participation,” Ben Finder, a senior analyst at MACPAC said.
More concrete information from the states was unavailable because the law does not require that states study the provision's impact.
Most states were at least four months late in making the enhanced payments because of delayed CMS guidance on the provision.
HHS has contracted with the RAND Corp. to analyze whether the rate bump has affected access to care, but that research won't be released until late next year, Finder said.
MACPAC also relied on a forthcoming study from the University of Pennsylvania and the Urban Institute. Researchers cold-called the same group of providers in 2012 and again in 2014 and found an 8% increase in willingness to see new Medicaid beneficiaries.
Still, the panel's members said they couldn't recommend an extension without better data.
“We would be going on faith now that it would make a difference to access,” said Dr. David Sundwall, vice chair of MACPAC and a clinical professor of public health at the University Of Utah School Of Medicine. “How are we going to make that recommendation if we're an evidence-based commission? We can't do it just because it's the right thing to do.”
MACPAC commissioner Judith Moore, a healthcare consultant in Annapolis, Md., agreed. If Congress did decide to extend the provision, lawmakers should attach a requirement that it be evaluated for success, she said.
Even if Congress doesn't extend the provision, 15 states—Alabama, Alaska, Colorado, Connecticut, Delaware, Hawaii, Iowa, Maine, Maryland, Michigan, Mississippi, Nebraska, Nevada, New Mexico, and South Carolina—all indicated that they will continue with the higher rates at least partially if not fully, according to a recent Kaiser Family Foundation study.
However, 22 states indicated that they would not be continuing the primary-care rate increase on their own. Another 14 states indicated they had not yet made a decision and were still evaluating whether the enhanced rates had any impact on provider participation.
Follow Virgil Dickson on Twitter: @MHvdickson