Medical Association Wary of Medicaid Reimbursement Cuts

11.23.2009 by Elizabeth Ziegler

(KCPW News) Medicaid reimbursement rates for medical providers could be slashed this year, according to early state budget forecasts. And this means more doctors will be shutting their doors to Medicaid recipients because they can’t afford to treat them, says Utah Medical Association Executive Vice President and CEO Michelle McOmber.

“When you can’t even cover the cost of seeing that patient — I’m not talking about any money going into the physician’s pocket, I’m just talking about the cost of providing that service, you just can’t continue to do it,” McOmber says.

State lawmakers have an estimated $850 million budget shortfall to contend with next year. They already enacted a 20 percent cut to Medicaid reimbursement rates for hospitals and a roughly 28 percent cut for dentists. Physician reimbursement rates are expected to take a double-digit cut next. Meanwhile, enrollment in Medicaid is climbing by about 1,500 new people each month, which is expected to cost the state an additional $50 to $75 million next year.

McOmber says lawmakers should stop considering Medicaid cuts and actually boost physician reimbursement rates. She says this would increase the number of Medicaid providers, and save the state money by keeping indigent patients out of emergency rooms.

“When a Medicaid patient can’t see or find a physician to go into or, you know, one that doesn’t take six weeks or eight weeks or however long to get into, often times, they’ll go into the emergency room, the most expensive care and it’s being used as a primary care setting,” McOmber says. “And that is the least efficient way to give primary care.”

But protecting or increasing physician reimbursement rates would require new revenues. That’s why McOmber says the Utah Medical Association will continue to support a proposal to increase the cigarette tax to help pay for health care costs.