Report author: The Lewin Group
This study examines the impact of three provider incentive payments: the Affordable Care Act Primary Care Incentive (PCIP), the short-lived Physician Shortage Area payment, and the Health Professional Shortage Area incentive payment on the availability of primary care practitioners and primary care services.
The study focused on the Medicare PCIP which increased the number of Medicare primary care providers by an average of 2.8 per county. Also the number of primary care physicians with a bonus eligible specialty increased by about 10 percent. There were more PCIP eligible claims per provider for one type of claim: the 25-minute visit for established patients. This was especially true of allowed charges for the eligibility threshold. While there was no significant incentive payment impact on allowed charges for the full sample of providers, for those who were near the PCIP eligibility threshold in 2009, increased charges of about $5600 annually were found in response to the policy. The study also models a fourth incentive payment, the ACA provision that for the years 2013 and 2014 primary care physicians providing Medicaid services be paid at no less Medicare rates.