Increased Reimbursement Boosts Appointment Availability

HealthDay News — Increased Medicaid reimbursement to primary care providers is associated with improved appointment availability, according to a study published in the New England Journal of Medicine.

Daniel Polsky, PhD, from the Perelman School of Medicine in Philadelphia, and colleagues measured the availability of and waiting times for appointments in 10 states during two periods from November 2012 through March 2013 and from May 2014 through July 2014. Trained field staff posed as Medicaid or privately insured enrollees seeking primary care appointments for new patients. The authors examined state-level changes over time in a stable cohort of primary care practices that participated in Medicaid.

The researchers found that between the two time periods there was a 7.7% increase in the availability of primary care appointments, from 58.7 to 66.4%. The largest increases in availability tended to be in states with the largest increases in reimbursements, with an estimated 1.25% increase in availability per 10% increase in Medicaid reimbursements (P = 0.03). In the private insurance group there was no such association observed. In the two study groups, waiting times for a scheduled new-patient appointment remained stable over time.

“Our study provides early evidence that increased Medicaid reimbursement to primary care providers, as mandated in the Affordable Care Act, was associated with improved appointment availability for Medicaid enrollees among participating providers without generating longer waiting times,” the authors write.


1. Polsky D, et al. N Engl J M. 2015;DOI: 10.1056/NEJMsa1413299