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Invited Commentary
August 2018

Reforming Payment for Primary Care—It’s Not Just the Money, It’s the Payment System

Author Affiliations
  • 1Division of General Internal Medicine, Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston
JAMA Intern Med. 2018;178(8):1049-1050. doi:10.1001/jamainternmed.2018.2607

Poor Medicaid reimbursement stands as a frequently cited cause of reluctance by many primary care practices to serve Medicaid’s expanding population.1 With payment rates a fraction of those for Medicare and commercial insurance, most primary care practices find Medicaid reimbursement insufficient. The expansion of Medicaid eligibility by the Patient Protection and Affordable Care Act (ACA) creates an urgent need to engage more primary care practices and, if already participating, to expand their Medicaid roles. To encourage this expansion, the ACA2 legislated a normalizing of Medicaid reimbursement so that the reimbursement matched Medicare fee-for-service (FFS) rates.

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    1 Comment for this article
    The Medical Care Restoration Act.
    John R. Dykers, Jr., MD | Chatham Hospital, UNC West, retired

    The Medical Care Restoration Act accomplishes what Dr. Goroll wants. Better learning, stronger doctor patient relationship, diminished "hassle factor", less defensive medicine, voluntary and still universal medical care. The act would return the non monetary rewards to the practice of medicine.

    CONFLICT OF INTEREST: None Reported
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