Medicaid pay action alert

Monday, January 04, 2016 11:22 AM
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Governor Hickenlooper, the Joint Budget Committee, and the state legislature are considering dramatic cuts in Medicaid reimbursement rates for evaluation and management (E&M) codes - as much as a 20+% rate reduction. These cuts would have a devastating impact on primary care and other specialty care physician practices across Colorado, limit access to care for Medicaid patients and undermine the growing strength of the Medicaid Accountable Care Collaborative (ACC).

The CMS board of directors and the House of Delegates designated this issue as a top priority. Earlier this month the Colorado Medical Society conducted an online poll that detailed how these cuts would impact physicians and their practices. The overwhelming response to the poll was that the proposed Medicaid E&M cuts are unacceptable.

Highlights include:

  • 37% of physicians took more Medicaid patients because of the enhanced rates;
  • More than 63% of respondents reported that the enhanced rates were important to their practice (somewhat important 23.6% and very important 40.1%); and
  • If the proposed cuts went through, then 37% of physicians would reduce Medicaid appointments and 23% would stop taking Medicaid. In addition, 15% would quit the ACC program and 36% would cut care coordination services and positions that have arguably been the backbone of ACC savings to date.

At this time, the state budget setting process is just getting underway and we need you to send a loud and clear message to your legislator who serves on the Joint Budget Committee.

Without delay Colorado Medical Society strongly encourages you to contact him or her and respectfully urge him or her to protect Medicaid reimbursement rates for primary care and other specialty care physicians. Some members of the committee have already committed to support our efforts to fight the proposed E&M code rate cuts, including Rep. Dave Young and Rep. Bob Rankin. Send a quick note of thanks to these legislative leaders. CMS staff has either yet to meet with or secure commitments from other JBC members, including yours, and that’s why your personal email to help convince them is critical.

Please click on your legislator’s name above to send him or her an email. Ask your legislator to prioritize and protect Medicaid reimbursement rates for physicians.

Consider cutting and pasting some of the following talking points in your note.

  • I am a Colorado physician writing to express my strong opposition to the proposed 20+ percent cut to Medicaid rates included in Governor Hickenlooper’s budget.
  • It is bad for access and bad for business: We rely on Medicaid revenue to run our practice. A 20+% percent reduction from one of our primary revenue sources could force us to limit the number of Medicaid patients we can take or drop out of the program entirely. It is also bad for businesses that buy private health insurance because underpayment from Medicaid will contribute more cost-shifting to the private sector and increased health insurance premiums.
  • It is bad for health care: Primary care is the backbone of a more efficient and effective health care system. Investing in primary care improves the health of our patients and lowers costs to taxpayers by keeping patients out of the emergency room. Colorado cannot sustain progress toward general population health without a durable network of primary care physicians and other caregivers.
  • It is bad for Colorado: Colorado has made great strides over the past few years to transform the Medicaid program through the Accountable Care Collaborative and other programs to enhance care coordination, quality improvement and cost containment efforts. In fact, the state just announced $285 million in gross savings over the past four years thanks in large part to efforts by physicians to enhance the value of Medicaid care. Progress and momentum are threatened if the rates are slashed. Physicians like me are being asked to do more and more when current rates don’t always cover our costs. The proposed, huge cut means we’ll have even fewer resources with which to do our work.
  • The state budget situation is grim, but balancing the budget in this way may actually INCREASE expenses and will have long-lasting impacts on our health care system. As the budget process proceeds, please work with your colleagues to prioritize and protect Medicaid reimbursement rates for physicians.

This quick and easy action should take you about five minutes, but will put legislators on notice that they can’t threaten patient health and undercut physicians without a fight.

Please join your colleagues in the Colorado Medical Society and other state specialty societies and speak up on behalf of physician practices and Medicaid patients today.



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