The NCMS legislative team has been working aggressively this week to address a revenue shortfall in the 2010-11 budget and to safeguard access to medical services in the Medicaid program. The Health & Human Services Budget Subcommittee Chairs completed their work this week after making a wide variety of additional cuts to meet the new budget shortfall that was discovered this past Monday. While the overall budget for Health and Human Services (HHS) has been reduced dramatically, provider rates are currently held to the rates that are being paid right now. This could all change if Congress does not extend the stimulus package for an additional six months of funding relief.
NC is counting on more than $500 million dollars in additional stimulus money that has yet to be approved. Senior leaders in both chambers have told the NCMS that the additional federal money is vital to maintaining the already reduced provider rates being paid. If congress fails to act in the coming week, budget writers in North Carolina are likely to be forced to make additional cuts to Medicaid. Physician and other medical provider service rates are most often mentioned as a place that cuts would have to be made in that scenario.
For years, legislators have been told that NC providers are being paid more than nearly every other state in the union. While the percentage of Medicare that NC providers receive for their rate may be higher than others, the actual dollars received are not significantly different because the base rates vary from state to state. In addition, if you compare participation in neighboring states, the number and quality of NC physicians caring for Medicaid patients is incomparable.
NC has worked for the last two decades to ensure that there is no difference between the care delivered to a citizen that can pay verses one of our neediest citizens. This is a goal that cannot be lost, even when money is tight. NCMS continues to advocate for the protection of physician services to ensure a robust network of physicians participating in the Medicaid program.
at 12:12 pm
You are right on target. Our state receives enhanced value for Medicaid dollars spent because almost all primary care physicians in NC see Medicaid patients. Enhanced access to primary care leads to fewer ED visits, fewer hospitlaizations and improved quality of acute and preventive care.
While physician payment accounts for less than 20% of the Medicaid budget, physician orders and care plans account for >80% of dollars spent. By having our physicians as partners with the state in providing the most cost-effective care, North Carolina has a Medicaid program that is the envy of the country.
If payments drop below the cost of providing the care, physicians will be forced to drop Medicaid patients.
Please keep advocating for us, NCMS.
Chuck Willson MD
Greenville