Putting a price on preventive care: How Medicaid compares to other insurers in Virginia
Medicaid has a reputation for paying doctors less than other health insurers. But exactly how much less has been difficult to establish, particularly for the vast majority of Medicaid patients whose care is provided through private health plans.
A new Virginia study led by George Mason University professor Alison Cuellar offers a clearer comparison of how much different types of insurance pay doctors for routine preventive visits. The study found that both forms of Medicaid, fee-for-service and managed care, paid substantially less than other types of insurance, such as Medicare, employer-sponsored insurance, and marketplace plans.
Medicaid managed care plans paid 25% less than Medicare plans and over 40% less than marketplace plans, despite generally paying more than traditional Medicaid. The study used novel Transparency in Coverage and Virginia claims data to provide a more complete picture of Medicaid payment rates, as previous studies have largely focused on traditional fee-for-service Medicaid.
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