Katz calls on Markell, JFC to rethink Medicaid reimbursement reductions

For Immediate Release: May 19

Senator Michael Katz, M.D., MBA issued a press release (below) and has sent a letter to the Governor urging him to rethink his position on making cuts to Medicaid (click here to read the text of the letter:
http://www.medicalsocietyofdelaware.org/LinkClick.aspx?fileticket=cex2IW...).

DOVER – Plans to cut what the state’s Medicaid program pays to doctors and other health care providers could wind up sending more people to the Emergency Room instead of a doctor’s office for treatment, Sen. Michael Katz, D-Centerville, said in a letter sent Thursday to Gov. Jack Markell.

Medicaid is a federal-state health insurance program for low-income families and the state’s Medicaid Advisory Committee recently proposed a series of measures, including cuts in reimbursements for medical, lab and non-emergency ER services to brace the state for possible cuts in federal Medicaid funding.

The proposed reductions are:

· 3 percent for most physician and radiology services

· 8 percent for lab services

· 75 percent for non-urgent Emergency Room service

Other proposals include limiting ER and special therapy visits and introducing co-payments for some medical services and for prescription drugs.

In his letter, which also was sent to members of the Joint Finance Committee, Katz said the cuts in reimbursements could have a chilling effect on health care. The JFC currently is in the midst of its rewrite of Markell’s $3.4 billion spending plan for the 2012 budget year that starts on July 1. Katz is the only doctor currently serving in the General Assembly.

“It is already a balancing act for those physicians who currently see Medicaid patients because the payments received for services provided, at best, barely cover the costs of providing them,” Katz wrote. “To further cut those payments … will shift the balance to the point that many physicians will be forced to close their practices to Medicaid patients.”

When that happens, he said, experience in other states show that the ER increasingly becomes the doctor’s office of necessity for Medicaid recipients.

Katz said a better option might be following the lead of North Carolina and developing what is known as a “Patient Centered Medical Home Initiative” in which one doctor or medical practice coordinates a patient’s care. The option has saved about $974.5 million for the state in six years.

Similar efforts are just getting started in Delaware and Katz said they have the potential of both improving care and cutting costs, if they’re allowed to take root.

“Sustaining the Medicaid program is obviously critical for Delawareans and no doubt a monumental task for the state,” he wrote. “Making the right choices now can yield positive benefits for years to come. Decisions made with only the short term in view, will yield disastrous results for both the state’s financial health and the health of our patients.”