From Deseret News archives:
Low reimbursement 'big concern' in Utah
Ranking 47th out of 50, the state's low reimbursement rates could leave many providers opting not to treat low-income patients, said Michael Deily, director of health-care financing for the Utah Department of Health.
"If we don't have an access problem today, we very well may have an access problem in the very near future," Deily told members of the Health and Human Services Interim Committee.
But as medical providers told lawmakers Wednesday, the low rates are already leaving them unable to afford to take on Medicaid patients.
"For us, this is a big concern," said Dr. Catherine Wheeler, president of the Utah Medical Association.
Wheeler, an obstetrician/gynecologist, said she will continue to serve existing patients who convert to government insurance programs such as Medicare and Medicaid, but will not accept new patients.
In her field, Medicare reimburses at 10 percent less than what private insurance pays. Medicaid is 30 percent less, Wheeler said.
For that reason, he said, few Utah dentists will even treat Medicaid patients.
The health department has recommended a 10 percent increase in reimbursement rates for children's dental services. Rep. Steve Mascaro, R-West Jordan, has proposed legislation that would statutorily increase rates for those services.
Sen. Allen Christensen, R-Ogden, a dentist himself, confirmed that low reimbursement rates are a problem.
"I see a large number of Medicaid patients because I feel like I owe it to them," Christensen said. "But I'm losing money for doing it."
Christensen said he is reluctant to send reminder cards to those patients, simply because he knows he'll lose even more money if they return.
For hospitals, which legally cannot turn away low-income patients, the situation is dire, said David Gessel, vice president of government relations with the Utah Hospitals and Health Systems Association.
Gessel urged lawmakers to consider the "abysmally low" rates when making budget decisions this year.
"I would just caution you . . . that over the last few years the Medicaid program has not perhaps had the same attention as other parts of the budget," Gessel said.
"This is the year to address the provider rates," agreed Judi Hilman, policy analyst with the research and advocacy group Utah Isues.
E-mail: awelling@desnews.com
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