Editing Medicaid (section)

==== Reimbursement for care providers ====
Beyond the variance in eligibility and coverage between states, there is a large variance in the reimbursements Medicaid offers to care providers; the clearest examples of this are common [[Orthopedic surgery|orthopedic procedures]]. For instance, in 2013, the average difference in reimbursement for 10 common orthopedic procedures in the states of New Jersey and [[Delaware]] was $3,047.<ref>{{cite journal |last1=Lalezari |first1=Ramin M. |last2=Pozen |first2=Alexis |last3=Dy |first3=Christopher J. |title=State Variation in Medicaid Reimbursements for Orthopaedic Surgery |journal=The Journal of Bone and Joint Surgery |date=February 2018 |volume=100 |issue=3 |pages=236–242 |doi=10.2106/JBJS.17.00279 |pmid=29406345 |s2cid=25818917 |url=https://digitalcommons.wustl.edu/cgi/viewcontent.cgi?article=7654&context=open_access_pubs }}</ref> The discrepancy in the reimbursements Medicaid offers may affect the type of care provided to patients.

In general, Medicaid plans pay providers significantly less than commercial insurers or Medicare would pay for the same care, paying around 67% as much as Medicare would for primary care and 78% as much for other services. This disparity has been linked to lower provider rates of participation in Medicaid programs vs Medicare or commercial insurance, and thus decreased access to care for Medicaid patients.<ref>{{cite journal | url=https://www.healthaffairs.org/doi/abs/10.1377/hlthaff.2020.00611 | doi=10.1377/hlthaff.2020.00611 | title=Medicaid Physician Fees Remained Substantially Below Fees Paid by Medicare in 2019 | year=2021 | last1=Zuckerman | first1=Stephen | last2=Skopec | first2=Laura | last3=Aarons | first3=Joshua | journal=Health Affairs | volume=40 | issue=2 | pages=343–348 | pmid=33523743 | s2cid=231755138 }}</ref> One component of the Affordable Care Act was a federally-funded increase in 2013 and 2014 in Medicaid payments to bring them up to 100% of equivalent Medicare payments, in an effort to increase provider participation. Most states did not subsequently continue this provision.<ref>{{citation | doi=10.1377/hpb20150511.588737 | title=Medicaid Primary Care Parity | year=2015 | doi-access=free }}</ref>