A recent study by the Harvey L. Neiman Health Policy Institute suggests that Medicaid patients in states with relatively higher reimbursement rates are more likely to receive medical imaging services.
The study, published in the Journal of the American College of Radiology, analyzed data from nearly 49 million Medicaid and Children’s Health Insurance Program (CHIP) beneficiaries aged 0-64 in 2019.
Medicaid reimbursement rates, which vary by state, were assessed using the Medicaid-to-Medicare reimbursement ratio (MMRR). This metric accounts for differences in Medicare rates across states, adjusted for regional variations in care costs.
“The median MMRR ranged from 0.76 for nuclear medicine to 0.87 for CT scans, indicating that Medicaid providers typically receive 76% to 87% of Medicare rates for imaging services,” said Eric Christensen, research director at the Neiman Health Policy Institute. “There’s significant variation among states — for example, the median MMRR for X-ray was 0.82, but in the lowest 25% of states, the ratio was 0.74 or less, while the top 25% approached or exceeded Medicare reimbursement.”
The researchers found a strong correlation between Medicaid reimbursement levels and imaging utilization. States in the 75th percentile of reimbursement saw up to 38% higher X-ray utilization compared to states in the 25th percentile. Utilization rates for CT, MR, and ultrasound were also lower by approximately 25-28% in states with lower reimbursement.
“While utilization is not a direct measure of access, it is a reasonable proxy,” said Elizabeth Rula, executive director of the institute. “Providers paid significantly less for Medicaid services may choose not to accept Medicaid patients, which could limit access. Our findings suggest that reimbursement rates directly impact care availability.”
The study highlights that disparities in reimbursement could contribute to broader inequities in healthcare access and outcomes, particularly for low-income and minority populations who rely on Medicaid. Increasing Medicaid reimbursement rates, the researchers argue, could help close these gaps and improve access to care.
