Doctors Will Get Less Money for Treating Medicaid Patients Starting in January
http://www.businessweek.com/articles/2014-12-18/more-medicaid-patients-less-money-for-doctors
Sandhills Pediatrics, a group practice near Fayetteville, N.C., recently hired a child psychiatrist and a psychiatric nurse practitioner. It also expanded a satellite office in Hoke County, where almost a third of children live in poverty. About half of Sandhills’ 20,000 patients are covered by Medicaid, the joint federal-state health program for the poor, and the practice was able to add the services thanks to a boost in the reimbursement rates Medicaid pays primary-care doctors under the Affordable Care Act.
The 2010 law guaranteed federal funding to cover the higher rates only in 2013 and 2014. President Obama’s proposed 2015 budget would have continued the higher payments, but that provision never made it into the $1.1 trillion spending bill Congress passed on Dec. 13. As a result, federal reimbursements will drop to 2012 levels starting in January. Sandhills expects its Medicaid revenue to fall 26 percent next year. “It means a tremendous loss,” says Sandhills managing partner Christoph Diasio.
Treating Medicaid patients is usually a money loser for doctors, which is why many physicians refuse to do so. The Affordable Care Act, which extended coverage to poor Americans by widening eligibility for Medicaid, added 9 million people to the program rolls. To encourage doctors to see them, Congress offered a carrot: Medicaid would pay the same rates as Medicare, the federal health insurance program for Americans older than 65. Medicare fees are generally higher than Medicaid fees.
Filed under: General Problems
Wasn’t this the ‘guaranted federal funding’ for higher Medicaid rates a big part of the “Cornhusker Kickback” that Sen Nelson got to get this fiasco passed and the Dems carrot to get all the states to expand their Medicaid coverage as part of their ‘exchanges’ and if everyone had been paying attention, like some of us did, you’d know that when the time was up, it would fall back on the states to pick up the huge budget busting Medicaid tab??? This is why many states opted out of forming their own exchanges. And more Medicare reimburesement cuts? Doctors opted out by dropping Medicaid and Medicare from their practices..More are dropping out of exchanges…going to cash….
This article is irrelevant. Providers are ditching Medicare patients left and right due to lack of appropriate reimbursement. Bringing Medicaid reimbursement levels up to Medicare levels is not going to solve the problem. The disparity is truly not alarming enough for this article to make any sense anyway.
According to the physician fee schedules from CMS and DMA the reimbursement for a mid-level established office visit (15 minutes) is $69 for Medicare and $54 for Medicaid. To say that a $15 difference is the make or break point is ludicrous and sensational.
Even if Medicare and Medicaid paid the same it would not matter. There would still not be an ‘arms wide open take all comers’ with Medicaid as this article would have us believe.