Medicaid Plan Would Aid Doctors, Hospitals

By Crisp, Elizabeth | St Louis Post-Dispatch (MO), February 5, 2013 | Go to article overview

Medicaid Plan Would Aid Doctors, Hospitals


Crisp, Elizabeth, St Louis Post-Dispatch (MO)


JEFFERSON CITY Missouri health care providers stand to see a significant boost in payments for treating Medicaid patients under Gov. Jay Nixons proposal to expand the health care program for the poor.

The budget proposal Nixon released last week would close a long- standing gap between what Medicaid pays for health care and what providers get on the private market, but it would also add millions to the federal governments tab for the expansion.

Supporters of the governors plan say increased Medicaid payments will encourage more doctors to accept patients from the Medicaid program, as several thousand people enter the system.

Opponents say the plan will increase costs charged to the federal government for implementing the optional provision of the federal Affordable Care Act.

Nixon, a Democrat, made the Medicaid expansion plan a key focus of his State of the State speech, but GOP leaders have largely balked at the proposal.

Its all a process, Nixon said Monday. My sense is were clearly moving in a positive direction.

The expansion would add some 260,000 Missourians to the program in the coming year, according to estimates from the governors budget office. The federal government already pays part of Missouris Medicaid costs. Under the federal health care law, it would pick up the full tab for new recipients in the first three years and continue paying most of the costs beyond that.

Nixons budget proposal calls for $907.5 million in federal spending for the influx of new Medicaid enrollees. That includes about $82 million to bring Medicaid payment rates up to commercial levels.

State budget director Linda Luebbering said the payment increase could ultimately make the program more efficient by drawing more doctors into the system, which could make cheaper preventive care more accessible.

By using rates that are closer to the commercial rates, we hope to encourage more active participation by doctors and other care providers, she said. If this proves to be a cost-effective strategy, we could broaden the concept to the rest of the Medicaid population.

The issue of how much health care providers should be paid for treating Medicaid patients isnt a new one for Missouri. The program is a state-federal hybrid, but payment rates are largely left to states to set.

Missouris program has long paid less money to doctors than they would get for providing the same services to patients who have private insurance or Medicare, a federal program for seniors.

The disparity has prompted some doctors to stop seeing Medicaid patients and led to repeated calls for rate increases.

Medicaid rates are just abysmally poor and they really limit what physicians can do in terms of providing Medicaid services, because they lose money every time, said Tom Holloway, executive vice president of the Missouri State Medical Association.

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