Extending Michigan’s Primary Care Incentive Program—Healthy Michigan

Under Michigan’s expanded Medicaid program, Healthy Michigan, nearly 600,000 additional Michiganders now have health insurance. This is a significant change for primary care providers due to the large influx of new patients seeking care. In order to meet the increased demand for primary care services expected under Medicaid Expansion and mandated insurance coverage, the Affordable Care Act provides for enhanced payments for eligible primary care providers who offer certain primary care services. The federal funding for these enhanced payments expired in 2014, leaving Michigan to create its own program to help support services for patients who were insured under Medicaid.

In order to continue to offer enhanced Medicaid reimbursement rates, Michigan was one of only 14 states to approve continuation of the Medicaid primary care fee uplift, funded entirely with state dollars. While Michigan's program does not have rates as high as the federal program does, it continues to provide higher rates than were authorized prior to 2013.

This reimbursement model and extension of enhanced Medicaid primary care rates enable family physicians to continue providing their patients with the services they need. As a result, these patients continue to have access to essential primary care services. Michigan’s uplift program allows for physicians who work specifically in family medicine, general internal medicine and pediatric medicine to be reimbursed at about 78 percent of Medicare rates for dates of service on and after Jan. 1, 2015, for the primary care services they provide.