PNHP

Medi-Cal's lesson for reform

Doctors say Medi-Cal reimbursement is too low

By Dustin Corcoran
San Francisco Chronicle, August 4, 2010

Medi-Cal covers essential health care services for the poorest and most vulnerable Californians, including seniors, pregnant women, children and people with disabilities. Despite the lifesaving care and preventive treatment that so many Medi-Cal patients have received, the state is planning drastic cutbacks to Medi-Cal that will irreparably harm patients and cost taxpayers more in expensive hospitalizations and emergency care.

The Legislature passed, and Gov. Jerry Brown signed, AB97, which includes a 10 percent reduction in Medi-Cal payment rates to physicians, hospitals, nursing homes and other providers, patient co-payments ($50 per emergency room visit, $5 per physician visit, $100 per day in the hospital), and a limit of seven physician office visits per year. If these cuts are allowed to take place, Medi-Cal would pay doctors just $11 per patient visit, just a fraction of what it would cost to take your dog to the veterinarian.

Cuts in reimbursement rates force physicians to reduce the number of Medi-Cal patients they can see, and now more than half of all Medi-Cal patients say they can’t find a doctor.

Currently, Medi-Cal is the source of health care for 1 in 5 Californians (about 7 million). With the implementation of health care reform right around the corner, 3 million more uninsured will soon be added to the state’s Medi-Cal program. But how can we adequately provide more care to more people with fewer resources? California already ranks last in Medicaid payment rates per enrollee.

http://www.sfgate.com/cgi-bin/article.cgi?f=/c/a/2011/08/04/ED4T1KIL9C.DTL

Comment: 

By Don McCanne, MD

California has a Democratic governor and a Democratic legislature, yet look at what they just did. Although California already ranks last in Medicaid payment rates, they are reducing payments another 10 percent. Much worse, they are imposing unaffordable co-payments on these low-income patients, and are not allowing them more than an arbitrary seven office visits a year. Punishment of patients and their health care professionals is not the reform that we needed.

Whether or not California is successful in obtaining federal approval to impose these cuts, this action confirms that we cannot allow our government to condemn low-income patients to a bottom-tier welfare program, yet this is precisely what the Affordable Care Act calls for.

Let’s fix Medicare and expand it so that we can bring in everyone under an umbrella that isn’t riddled with leaks.

Medi-Cal’s lesson for reform

Doctors say Medi-Cal reimbursement is too low

By Dustin Corcoran
San Francisco Chronicle, August 4, 2010

Medi-Cal covers essential health care services for the poorest and most vulnerable Californians, including seniors, pregnant women, children and people with disabilities. Despite the lifesaving care and preventive treatment that so many Medi-Cal patients have received, the state is planning drastic cutbacks to Medi-Cal that will irreparably harm patients and cost taxpayers more in expensive hospitalizations and emergency care.

The Legislature passed, and Gov. Jerry Brown signed, AB97, which includes a 10 percent reduction in Medi-Cal payment rates to physicians, hospitals, nursing homes and other providers, patient co-payments ($50 per emergency room visit, $5 per physician visit, $100 per day in the hospital), and a limit of seven physician office visits per year. If these cuts are allowed to take place, Medi-Cal would pay doctors just $11 per patient visit, just a fraction of what it would cost to take your dog to the veterinarian.

Cuts in reimbursement rates force physicians to reduce the number of Medi-Cal patients they can see, and now more than half of all Medi-Cal patients say they can’t find a doctor.

Currently, Medi-Cal is the source of health care for 1 in 5 Californians (about 7 million). With the implementation of health care reform right around the corner, 3 million more uninsured will soon be added to the state’s Medi-Cal program. But how can we adequately provide more care to more people with fewer resources? California already ranks last in Medicaid payment rates per enrollee.

http://www.sfgate.com/cgi-bin/article.cgi?f=/c/a/2011/08/04/ED4T1KIL9C.DTL

California has a Democratic governor and a Democratic legislature, yet look at what they just did. Although California already ranks last in Medicaid payment rates, they are reducing payments another 10 percent. Much worse, they are imposing unaffordable co-payments on these low-income patients, and are not allowing them more than an arbitrary seven office visits a year. Punishment of patients and their health care professionals is not the reform that we needed.

Whether or not California is successful in obtaining federal approval to impose these cuts, this action confirms that we cannot allow our government to condemn low-income patients to a bottom-tier welfare program, yet this is precisely what the Affordable Care Act calls for.

Let’s fix Medicare and expand it so that we can bring in everyone under an umbrella that isn’t riddled with leaks.