Medicaid

Virginia ranks 48th nationally in Medicaid expenditures per capita. Cuts to physician Medicaid reimbursement further jeopardize access to care for the most vulnerable of Virginia’s patients. In a recent MSV physician survey (January 2009), 57.6 percent of respondents indicated they will reduce the number of Medicaid patients they care for if payments are reduced by 3 percent. Physicians treating Medicaid recipients are currently reimbursed well below their cost of providing care, forcing many to no longer accept Medicaid patients and others to close their practices. Physicians with specialties in obstetrics, pediatrics, family practice and emergency medicine have been particularly hard hit by these inadequate reimbursement rates.

Although the commonwealth has made efforts to increase physician Medicaid rates in specific areas of service, there has never been an effort to develop a long-term solution. The absence of a Medicaid inflation update for physician services has seriously eroded rate adequacy and created a significant and growing access to care challenge for Virginians who participate in the Medicaid program. An inflation factor is not a new concept; Virginia’s hospitals and nursing homes receive a Medicaid inflation adjustment annually. Health care funding must become a priority for state government just like elementary and secondary education, transportation and public safety.

MSV has been successful in winning increases in Medicaid reimbursement. However, these increases have been nonexistent as of late, given the current economic climate. Instead, reimbursement rates were proposed for reduction by the Virginia Senate during 2009’s General Assembly. MSV successfully protected physician Medicaid rates, thereby protecting access to care at a time when Virginia’s unemployment rate is increasing. Virginia physicians must fight to protect Medicaid from reductions and push for increases in reimbursement.

Resources

For Virginia Medicare and Medicaid physicians: Spring update on policies from CMS (PDF)
Spring 2009

Medicaid Reimbursement Rates FAQs

2008 Protect Medicaid Reimbursement Background (PDF)