Virginia Study Reveals Medicaid Pays Doctors Substantially Less Than Other Insurers for Preventive Care
A new study from Virginia, led by George Mason University professor Alison Cuellar, has found that Medicaid pays doctors substantially less than other health insurers for routine preventive visits. The research, set to be published in JAMA Health Forum, compared payment rates across different types of insurance, including traditional fee-for-service Medicaid, Medicaid managed care, Medicare plans, employer-sponsored insurance, and marketplace plans. The study revealed a consistent divide: both forms of Medicaid paid significantly less. Specifically, Medicaid private managed care plans paid 25% less than Medicare plans and over 40% less than marketplace plans, even though they generally paid more than the state’s traditional Medicaid program. This study utilized novel Transparency in Coverage and Virginia claims data to provide a more complete picture, especially considering that about 85% of Medicaid members nationwide are enrolled in Medicaid managed care.
