Politicians talk a good talk about the importance of primary care and preventive medicine.
They they go ahead and cut Medicaid payment rates to doctors and hospitals. They are likely to be across-the-board, with hospitals fearing “there’s no scalpel in any of this; it’s all whack, whack, whack.”
Physicians will be fine. More will simply join the majority that no longer accepts Medicaid.
Patient however, again lose. Although hospitals won’t like cut inpatient units or the emergency department, it will be the community-based clinics that will feel the brunt of the cuts.
These outpatient venues form the pillar of any proposed universal coverage plan, and have been shown to slow health care spending. It continues to amaze me that government continues to take a short-sighted approach to cost cutting that will cripple any chances of health reform success.
Related posts:
- California is cutting Medicaid payments
- Cutting Medicaid payments
- How cutting Medicaid payments hurts patients
- With Medicaid cuts looming, guess who’s supporting doctors?
- The folly of cutting physician reimbursements
- What happens if the safety net clinics start refusing to see Medicare or Medicaid patients?
- This is your reward for continuing to take Medicaid patients
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Private practice physicians will be fine.
Employed physicians in hospitals and large multispecialty groups will now need an even bigger internal subsidy to keep their primary care clinics afloat. This will increase the pressure to see more patients faster, reduce staff, or make other cuts. The money has to come from somewhere.
I am a family practitioner in upstate New york, so I know this topic very well. As bad as medicaid is, “rich”, “enlightened” New York State has one of the worst medicaid program in the country. For example, the average time for claims proocessing is almost 115 days!
Primary care visits are reimbursed at approximately 30 dollars a visit, regardless of complexity. Many preventative services are not covered.
Only an idiot practicing in New York would accept medicaid.
Why is medicaid worse than usual in our state? I am not sure, but one possible explanation is “Article 28″ clinics, usually run by hospitals and teaching programs, that have been filling in the gaps. However, these tend to be bloated bureaucracies that are far from cost effective. In typical “shock doctrine” style, maybe starving these beasts is necessary.
The irony is that if medicaid reimbursement to primary care was fair, these patients would be getting exemplary care in private offices and overall keep costs low.
Ho-hum. How short sighted can politicians and state governments be?
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