Study shows Medicaid cuts will threaten physician network in Virginia
Richmond, VA – A new survey conducted by the Medical Society of Virginia (MSV) shows that access to physician care will be significantly reduced throughout the state if the General Assembly cuts the budget for Medicaid physician payments by even 3%. In a state that enjoys higher than average per capita income (ranked 8th in 2007), Medicaid spending per capita ranks 48th nationally*. Additional reductions would have severe consequences for vulnerable populations including children, the elderly, expectant mothers and the disabled, all who rely on Medicaid for the primary care they need.
Although physicians are not currently facing a reimbursement cut in the proposed budget, concerns about that possibility led the MSV to assess how cuts like these could affect patient access to care.
More than 86 percent of survey respondents noted that they currently accept new Medicaid patients or continue to care for their existing Medicaid patents. However, when asked if they would have to make changes to accepting new or treating established Medicaid patients if Medicaid payments are reduced by 3 percent, nearly 58 percent responded that they would have to reduce the number of existing Medicaid patients they treat, reduce the number of new Medicaid patients, stop accepting new Medicaid patients or stop caring for all Medicaid patients.
When asked about a potential 5% or greater reduction, the number of physicians that anticipate having to reduce or stop seeing Medicaid patients rose to greater than 65 percent.
Virginia physicians have already been notified by one private sector Medicaid Managed Care plan that, due to the state budget difficulties, they have made the decision to eliminate the $3 per member per month patient management fee. They have also reduced specialists’ fees by 3%. This seemingly small reduction will have significant consequences as well. Nearly 65% of primary care physicians will have to reduce the number of new or established Medicaid patients they treat or may stop providing medical management for Medicaid patients.
“The data clearly show that Medicaid cuts will have a disasterous effect on the accessibility of physician care to a growing number of uninsured Virginians,” said Thomas Eppes, Jr., MD, president of the Medical Society of Virginia. “The decision to reduce or stop seeing Medicaid patients is not one that any physician wants to make. However, as business people, we are facing the same challenges and realities as other businesses. We already are compensated at or below the cost for providing care to Medicaid patients and subsequent cuts may be more that many practices can absorb,” he said.
The Medical Society of Virginia has heard from physicians like Lina Sue Crowder in South Hill, VA. She works for a financially struggling rural community health center. If Medicaid reimbursements are cut, the health center will likely have to close unless additional financial relief is provided.
Dr. Thomas Templeton is a part time anesthesiologist (one of two) at a small community hospital. He does not do the billing for his services or decide on which patients to accept, but rather provides care for all patients that surgeons bring to the operating room on the days that he works.
“The hospital has a greater percentage of Medicaid/Medicare/charity patients than most, and this will probably get worse with the present economy. Our hospital is operating at a loss, and I have no idea how they would deal with decreased reimbursement from any significant portion of their patients, including Medicaid.
“The surgeons I work with discuss how reimbursement from Medicaid does not cover the patient's share of office and malpractice insurance expenses. Most are willing to provide some “free" care to patients in need, but when they are losing money, it becomes a threat to the viability of their practice. A few years ago, one general surgeon retired early and an ENT surgeon relocated because their practices were no longer financially viable,” said Dr. Templeton.
I fear that it may affect the ability of those doctors that are still in the area to accept Medicaid patients, the number and specialty representation of doctors in the community, and perhaps even the long term viability of the hospital itself.”
The Medical Society of Virginia is the professional association for physicians in the commonwealth. Dedicated to supporting physicians in the practice of medicine, MSV advocates on their behalf to ensure physician influence on health care legislation and policy improvements and provides a variety of educational and support activities that assist physicians in the practice of medicine.
* Department of Medical Assistance Services, The Virginia Medicaid Program at a Glance, January 2009
Medical Society of Virginia Medicaid Survey Responses
DISTRIBUTION
Sent to 5,885 physicians across the Commonwealth of Virginia. There were 564 respondents.
RESULTS
- 68.6 percent are currently accepting new Medicaid patients
- 18.8 percent currently treat established but are not accepting new Medicaid patients
- If Medicaid payments are reduced by 3 percent:
- 57.6 percent will have to make changes to the number of Medicaid patients they care for
- Of those currently accepting new Medicaid patients
- 18.9 percent will reduce the number of new Medicaid patients they accept
- 15.3 percent will stop seeing new patients
- Of those treating only established Medicaid patients
- 24.5 percent will reduce the number of established Medicaid patients
- 23.6 percent will stop seeing all Medicaid patients
- Of those who care for pediatric Medicaid patients
- 52.2 percent will have to make changes to the number of Medicaid patients they see
- If Medicaid payments are reduced by 5 percent or greater:
- 66.8 percent will have to make changes to the number of Medicaid patients they care for
- 40.8 percent will reduce the number of established Medicaid patients or the number of new Medicaid patients accepted
- 26.1 percent will stop seeing all Medicaid patients, including those already seen by the practice
- Of those currently accepting new Medicaid patients
- 60.5 percent will have to make changes to the number of Medicaid patients they see
- 15.8 percent will reduce the number of new Medicaid patients
- 19.1 percent will stop seeing new Medicaid patients
- Of those treating only established Medicaid patients
- 19.8 percent will reduce the number of established Medicaid patients
- 43.4 percent will stop seeing all Medicaid patients
- Of those who care for pediatric Medicaid patients
- 58.6 percent will have to make changes to the number of Medicaid patients they see
- If the per member, per month $3 administrative fee is eliminated
- 64.9 percent of primary care physicians will have to make changes to the number of Medicaid patients they see
- 41.5 percent will reduce the number of established Medicaid patients or the number of new Medicaid patients accepted
- 23.3 percent will stop seeing all Medicaid patients, including those already seen by the practice
Margin of Error: +/- 3.92 percent
Contact:
Rachel Mertz
804 | 377-1024
804 | 517-0049 cell
Karen Batalo
804 | 262-9130
804 | 337-3045 cell
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