Boston Medical Center, where I trained for residency, is going through some tough times.
With the highest proportion of poor and indigent patients in the city, they were disproportionally hurt when Massachusetts chose to lower Medicaid payments.
The direct result was the announcement that they would lay of 250 employees. The reductions were widespread, including “clinical and administrative services . . . including obstetrics, primary care, pediatrics, family medicine, geriatrics, laboratory, radiology, nursing, endoscopy, urology, and ophthalmology. Interpreter services, information technology, public safety, and dietary services are also seeing cuts.”
At a time when the hospital “is seeing record numbers of patients,” there will now be longer wait times, less ancillary staff to support clinicians, an inability to obtain an interpreter, and less staff to do public outreach.
This is precisely why patients lose whenever payments are cut.
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Medicaid cuts are at least one thing primary care physicians don’t need to worry about. We stopped taking medicaid years ago. They were always the toughest patients (both illness and attitude wise) and the reimbursments don’t cover 5 minutes of overhead.
What’s happening across the country to Medicaid is a preview of what’s going to happen to your other patients: cutting off access to primary care in the form of higher dedutibles, co-pays or loss of coverage all together, as strapped companies try to weather the recession. This is a public health nightmare and wastes money ultimately as simple problems become big expensive problems and everything is dropped into the hospital’s lap as the place of last resort.
You do need to worry about the financial health of your hospital and whether your ED has capacity to handle your patient’s true emergencies, don’t you?
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