Medical providers worried by proposed Medicaid rate cuts - bizjournals:

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A proposal from a House appropriations subcommittee for healthg and human services releasecd this week would eliminate an annuaol inflation adjustment to physician payments and furthef reduce reimbursement ratesby 5.5 perceng this year and 6 percent next The rate cut alone would equal $148 millioj less in state funds goint to doctors during the fiscal year that begins July 1. Medicaid is a federap program that provides health insuranceto low-incomes children, parents and seniors as well as the States share about a quarter of the so a reduction in state funds wouldd also mean about $444 million less from federal matching fundxs in fiscal 2010.
Exact estimates for the Triad were unavailable, but basedx on the region’s share of Medicaird dollars inpast years, the rate cut alone coule mean local providers will receiver about $92 million less this year. The federalk stimulus program also includes provisions for extra Medicaid paymentseto states. But those too, are based on matching state andthe N.C. Medical Society is concerneed that slashingthe state’s Medicaid budget could jeopardize that money as “We’re sensitive to the fact that the budgef has to be balanced,” said Carolynm Green, practice administrator at Piedmont Senior Care in Greensboro.
“But they’re taking away from the people who can leasytafford it. Hospitals, physicians and Medicaide patients are all goingto suffer, because doctorxs are going to stop seeing and the hospitals will be the ones who see an even biggert share of indigent The move comes as legislators are grappling with a $4.6 billionm overall state budget deficit, and nearluy every department is bracing for cuts, from higher education to publix schools to roads and the arts.
While interesf groups representing all areas of state spending have lobbied to maintain theie share of the budget or tominimiz cuts, legislators have warned that no portion of the budget can be sparedx given such a massive budget shortfall. “There are devastatin g cuts all overthe it’s awful,” said Rep. Pricey a Democrat from Greensbori who is vice chairman of the Housrappropriations committee, but did not serve on the health “It’s a pretty universally sharecd sentiment that the budget is pretty draconian.
” Just the doctors, dentists, hospitals, hospice groups, home health agenciew and other providers are concerned the proposedd cuts could also come as the recessionh is forcing more and more patients to seek Medicaidf assistance. The N.C. Medical for example, has urged its memberxs to draw a straight line between Medicaif payments anda community’s overall economic health when lobbyinfg legislators. “A lot of money paid to providers is used forpersonneo salaries,” said Mike Edwards, a spokesman for the “The effect of the cuts would be and you would see a loss of local spendingf and economic activity.
” The Medicaid populatiob in the state and Triad has risen steadily each year sincs 1999, due in part to overal l population growth. But the rise has become more dramatix in the pasttwo years. Stevwe Owen, chief business operating officer forthe N.C. Divisioh of Medical Assistance, said the Medicaid rolls had been growing about 3 percenta year, but they grew nearlh 7 percent in fiscal 2009 and will likelhy be up more than 8 percent in fiscal 2010. It’w a function, Owen said, of the recession causing more people to meetthe low-incoms requirements for assistance. Doctors say they’rwe already taking a loss when they seeMedicaidx patients.
Medicaid in North Carolina pays 95 percent of what each countyy sets for paying bills associatedwith Medicare, the otherd federal insurance program for seniors. Yet doctors argue that Medicare reimbursementsalso aren’t enoughn to cover their true costs of care. North Carolina’s Medicaid reimbursement rate is amonfg the highest inthe nation, but Mary Ellen Workman, administratore at in Greensboro, said that should be a sourcre of pride and should sway legislators to maintaib payment levels. “It’s about takingb care of your poorest citizen s inNorth Carolina,” she “If you start letting your health care erodde like that, it just creates more problems.
Access to care is goingb to be ahuge issue.” Workman said physician practices acrosz the state are already limiting how many Medicaie patients they will accept. As a result, thoser patients may have nowhere to go exceptg localemergency rooms, which are already overflowing with uninsurede patients causing millions of dollarzs in losses for hospitals. Joanne vice president of governmenrt affairsat , said the reimbursement rate cut coul also be coupled with other proposals to cut servicesa or increase the co-payu required of Medicaid That, in turn, couldr cause those low-income patients to put off care and wait unti l they require more expensive treatment.
“We are already bearinyg the cost of thiseconomic crisis,” Ruhland said. “And then we’re facec with a situation where these patients come to us later on withadditional problems. We have to let our (legislators) know so they understand how this cuts into our abilit y to take care of the poor in our regio andour state.”