- 26 Laura Snyder et al.,Why Does Medicaid Spending Vary across States: A Chart Book of Factors Driving State Spending (Washington: Kaiser Family Foundation, 2012), accessed Feb. 19, 2014, http://kaiserfamilyfoundation.files.wordpress.com/2013/01/8378.pdf.
- * This statement refers specifically to provider reimbursement rates in Medicaid fee-for-service programs. In Medicaid managed care programs, states contract with managed care organizations, or MCOs, to deliver care for a set fee; data are not available on the rates at which MCOs reimburse their contracted providers. Approximately 70 percent of Medicaid enrollees are served through managed care delivery systems. (Source: Centers for Medicare & Medicaid Services, "Financing & Reimbursement," accessed April 15, 2014, http://www.medicaid.gov/Medicaid-CHIP-Program-Information/By-Topics/Financing-and-Reimbursement/Financing-and-Reimbursement.html.)
- 27 Stephen Zuckerman and Dana Goin,How Much Will Medicaid Physician Fees for Primary Care Rise in 2013? Evidence From a 2012 Survey of Medicaid Physician Fees (Washington: Kaiser Commission osn Medicaid and the Uninsured, 2012), accessed Jan. 16, 2014, http://kaiserfamilyfoundation.files.wordpress.com/2013/01/8398.pdf.
- 28 Stephen Zuckerman, Aimee F. Williams, and Karen E. Stockley, "Trends in Medicaid Physician Fees, 2003–2008,"Health Affairs 28, no. 3 (2009), accessed April 15, 2014, http://content.healthaffairs.org/content/28/3/w510.abstract.
For state-by-state data please see the tables below.
Total Medicaid spending, per enrollee
On a per-enrollee basis, Medicaid spending has remained relatively stable over the past decade, rising by only 5 percent after adjusting for inflation, from $5,956 in 2000 to $6,254 in 2010. This is substantially less than the overall health care spending per resident in the United States, which increased by 39 percent over the same period to just over $8,700 per resident.
While spending in Medicaid is subject to many of the same cost drivers as overall health care, its costs are moderated by several factors, including low provider-reimbursement rates.26,* In 2012, for example, Medicaid paid physicians on average 66 percent of what Medicare paid for services, down from 72 percent in 2008. Furthermore, both Medicaid and Medicare pay providers significantly less than what they receive from private payers.27 Low reimbursement rates decrease the willingness of providers to treat Medicaid enrollees, which sometimes limits enrollees' access to health care services.28