Effects of the Affordable Care Act Medicaid Expansion on the Compensation of New Primary Care Physicians

Bibliographic Data

ID9101332
AuthorsYanlei Ma (0000-0002-0632-5258, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, corresponding author), David Armstrong (0000-0003-3652-9662, Center for Health Workforce Studies, School of Public Health, University at Albany, SUNY, Rensselaer, NY), David P Armstrong (University at Albany, State University of New York), Gaetano J Forte (Center for Health Workforce Studies, School of Public Health, University at Albany, SUNY, Rensselaer, NY), Gaetano Forte (University at Albany, State University of New York), Hao Yu (0009-0004-5499-5565, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, corresponding author)
Year2022
Volume60
Issue8
Pages636-644
Publication date2022-08-01
Open AccessNo
TypeARTICLE
VenueMedical Care (JOURNAL)
Journal identifiersISSN: 0025-7079 • E-ISSN: 1537-1948
PublisherOvid Technologies (Wolters Kluwer Health) (PUBLISHER)
DOI10.1097/mlr.0000000000001740
PMID35640053
OpenAlexW4282913150
LanguageEN
Citations received2
References cited10

BACKGROUND: It is well-documented that the Affordable Care Act Medicaid expansion increased health care utilization by low-income Americans. Emerging studies also found that the expansion changed the geographical distribution of new physicians. However, the effect of the expansion on physician compensation has not been studied. OBJECTIVES: We aimed to assess how the Medicaid expansion affected the compensation of new primary care physicians (PCPs) and whether the effect differed by specialty, gender, and geography. RESEARCH DESIGN: We used a quasiexperimental difference-in-differences design to assess changes in compensation for new PCPs from before to after the Medicaid expansion in states that expanded Medicaid compared with states that did not expand. SUBJECTS: Our study included 2003 new PCPs who responded to the Survey of Residents Completing Training in New York between 2009 and 2018. MEASURES: Our primary outcome was respondents' self-reported starting salary for their first year of practice. Our secondary outcomes were respondents' self-reported additional anticipated income and incentives they received for accepting the job offer. RESULTS: We found that starting salaries for new PCPs, especially new general internists and family physicians, grew faster in expansion states than in nonexpansion states. In addition, we found that the expansion was associated with a statistically significant increase in receiving additional anticipated income as part of the compensation package for new PCPs practicing in rural areas

Compensation (psychology) · Family medicine · Health care · Health insurance · Incentive · Medicaid · Patient Protection and Affordable Care Act · Political science · Primary care · Primary care physician · Salary · Specialty · Global Health Workforce Issues · Healthcare Policy and Management · Medicine · Primary Care and Health Outcomes · Psychology

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