Increasing State Medicaid Payment Rates

Leadership is often misunderstood and always undervalued as in this example from Obama Admin

July 6th, 2012 · No Comments


Oil Spill Timeline from RightChange on Vimeo.

A colleague of mine who spent years working with the offshore oil and gas industry in Huston TX sent me this as a reminder of how the Obama administration lack of leadership when faced with complex issues like natural disasters or an economy in peril. The focus of this failed administration is to campaign for reelection by blaming everyone outside the administration. Leaders find a way to move forward in fact not just in slogan.

Consider this about the healthcare legislation. Was this bill a well thought out approach to reform or a legacy consideration? I believe it was the latter given its compromises in almost aspect of healthcare including its failure to address the cost going forward. Expansion of medicaid with no means to provide the service capacity of doctors and nurses is just one of the problems it fails to address. Their may not be a complete repeal and replace but their must be substantial overhauling for any part of this program to work. If only the legislation could deliver on the rhetoric presented in its public justification.

Medicaid physician payment rates hurts primary care doctors

Fiscal year 2009 saw the largest ever one-year increase in Medicaid recipients. Nationwide, enrollment grew 7.5% — more than double the previous year’s 3.1% growth rate — to 46.9 million. In the Philadelphia region, Medicaid enrollment increased 8% in 2009, 18% in the past two years.

Yet, because states must balance their budgets yearly, and Medicaid comprises a large portion of these budgets, Medicaid becomes a prime target — just at a time when increases are needed.

The American Recovery and Reinvestment Act’s stimulus money brought significant increases in federal Medicaid matching rates, providing an estimated $87 billion to states over a nine-quarter period. But that extra funding is scheduled to end Dec. 31, 2010. And to date, state revenues show no signs of recovery.

Meanwhile, governors and hospitals across the country are advocating for a six-month extension of the federal Medicaid matching rates through June 2011.

It’s important that state leaders understand the financial burden that Medicaid underpayments place on providers.

The recently enacted federal healthcare reform legislation acknowledges as much, increasing state Medicaid payment rates for primary care physicians to Medicare levels in 2013 and 2014. But hospital providers also need Medicaid payment increases.

Beginning in 2014, the healthcare reform legislation also requires state Medicaid programs to cover people making up to 133% of the federal poverty level. This expansion could result in more than 15 million more Medicaid enrollees — regardless of what the economy does.