Doctors face big cuts in Medicaid pay
Andy Pasternak, a family doctor in Reno, saw more than 100 new Medicaid patients last year after the state expanded the insurance program for the poor under the Affordable Care Act.
But he won’t be taking any new ones this year. That’s because the law’s two-year pay raise for primary care doctors like him who see Medicaid patients expired Wednesday, resulting in fee reductions of 43% on average across the country, according to the non-partisan Urban Institute. USATODAY.com
Here is a classic bait and switch. Raise the fees paid to physicians for Medicaid patients to the level for Medicare, but for only two years. Then expand Medicaid, increase patient loads and drop the fees paid.
Everyone wants the expansion of this or that social program and many people accept it all on face value without questioning the impact on costs for everyone.
If you are a physician what you are paid for an office visit for example varies by the patient.
Self pay $$$$$
Managed care insurance $$$$
Other insurance $$$ [variables by insurer]
Medicare $$
Medicaid $
Are we nuts? Well yes, we are. Why shouldn’t a single fair payment be made by all the above payers? Money and politics are two answers that come to mind. And if you are nearer the top of this list, remember you are subsidizing all the others (in addition to the taxes you pay to support the public programs).
And there is another issue some would raise, will every physician devote the same time and effort to Medicaid patients knowing they may be under reimbursed or even losing money on each visit? Ethics say they will and I suspect that to be the case in most offices, but these are businesses too and they have bills to pay as well.
Everything is connected and yet we try and fix problems as if they are totally independent. It doesn’t work that way. In this case some states are keeping the Medicare level fees and paying the extra cost. Who do you think is carrying that burden … the same middle class who we are told is struggling. 😏
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