Fall 2013: Econ 339 Final Presentation

1. Fall 2013: Econ 339 Final Presentation David Minion 11/21/2013 “The effect of Medicaid physician fees on take-up of public health insurance among children in poverty” Youjin Hahn, The effect of Medicaid physician fees on take-up of public health insurance among children in poverty, Journal of Health Economics, Volume 32, Issue 2, March 2013, Pages 452-462, ISSN 0167-6296, http://dx.doi.org/10.1016/j.jhealeco.2013.01.003. (http://www.sciencedirect.com/science/article/pii/S0167629613000040) Total:_________

2. Introduction • Medicaid was created in 1965 • Most children below poverty line are eligible for public insurance • Uninsured rate remains high • “Eligible but not enrolled”

3. Background • Office- Based Primary care physicians place limit on number of Medicaid patients • Medicaid patients have problems accessing health care • 40% report problem getting a referral • 21% privately insured reported same problem

4. Medicaid physician fee is set by each state • Variability amongst states • Each state sets its own payment level

5. Results • Increases in fees result in: • higher quality and more timely access to care • Reduced uninsured rate • More physicians accept Medicaid

6. Results Cont. • 10% increase in fee raises take-up by 1.38% • 10% change in fee results in a 10% reduction in uninsured rate • 10% increase in fee leads to reduction of 45,800 low-income uninsured children

7. Conclusion • Long- term benefits outweigh short term costs of insuring the children • Access to care leads to greater nutrition and health utilization • Low income see improvements in learning ability and productivity • Greater payments to physicians would significant increase the take-up of Medicaid.