Governor Craig Benson?s proposed state budget reduces Medicaid reimbursement rates by 5%. Medical providers say New Hampshire?s reimbursement rates are already too low. Rural doctors and hospitals say the cuts will make it even more difficult to deal with soaring healthcare costs? And for low-income families to get the healthcare they need.
NHPR's Raquel Maria Dillon reports.
Dr. Robert Soucy has a small practice in Colebrook. He says he?s already struggling with low reimbursement rates.
SOUCY :17 it?s hard enough for me to eat the problem with medicare from the fed gov?t where they?re cutting close to 10% out of my hinney. That?s very difficult to swallow. Now my governor has me on a 5% cut.
Soucy says there?s a direct connection between government payments and quality of care. He says his practice is already down one doctor and one nurse.
SOUCY :17 When gov?s budget cut by 5% it makes it very hard to recruit in the area. I can?t offer as much as they can in Nashua so the underlying problem is when you cut Medicaid you deliver less service to my area.
He says he and his staff are committed to serving the Colebrook community where they live and raise their families. But Soucy says, even if Concord lawmakers don?t share that commitment, he hopes they would find the economic argument just as persuasive.
SOUCY :15 These are the folks who you have to intervene early. Or they end up in ER at a cost of 1000s. things that I can fix for under 100s. it?ll cost thousands when they show up in the ER.
That?s what Henry Lipman is worried about. He?s the Executive Vice President of Lakes Region General Healthcare. He says if the proposed cuts go through, rural hospitals will be in trouble too.
LIPMAN :11 The impact on rural areas hits disproportionately because they have greater dependency on Medicaid for source of payment.
For example, Franklin Hospital gets 10% of its revenue from Medicaid ? and that?s twice state average.
On top of the cuts, Lipman says hospitals will end up seeing more and sicker patients in emergency rooms ? patients who can?t get preventive and primary care because doctors won?t see them.
Many medical provider keep their practices afloat by seeing a blend of patients ? some covered by Medicaid, others by Medicare, and the rest by private health insurance companies. Lipman says, if doctors are faced with rate cuts, they won?t dump their patients?
LIPMAN :12 But when it comes to accepting new patients or patients they haven?t seen before patients new in community. That?s where its easier for them to draw the line. Because they?re not required by law to see them.
Hospitals have to treat whoever walks into the Emergency Room. Lipman understands the Governor?s goals, but he says his plan is shortsighted.
LIPMAN :19 we don?t want new taxes. But what ends up happening is cost gets shifted on to other people. Exacerbates health insurance cost issue. Or leads to a reduction in services. Both not factored into equation.
Community health centers are also bracing themselves. Families First provides healthcare to low-income families on the Seacoast. Executive Director Helen Taft says she?s squeezed from two sides. Community health centers like hers are level-funded in the governor?s budget, while healthcare costs continue to rise. In addition, any reduction in state Medicaid reduces the amount of federal support going to the center.
TAFT :18 community health centers operate on very slim margin as it is. Always trying to balance budget, because we?re always service more uninsured. Just in past year, # of uninsured increased by 31%. We don?t see that declining.
Taft says her options are to cut services, or work to find other sources of income through fundraising.
Governor Benson says the 5% cut will save the state nine million dollars.
As an incentive for the medical community, Benson promised to make up for the reimbursement cuts with medical malpractice reform. But organizations and practitioners who serve the needy say that?s not enough to make them go along with the cuts quietly.
TEFT :17 certainly doesn?t appear to me to be an equal swap. 1% of budget -- not nearly the impact of 5% in Medicaid. Reality is, as safety net orgs, you can?t easily absorb cuts coming from HHS budget, long term they might help, but not on short term.
Taft has been through budget-balancing before. She?s hoping that by the time the budget makes its way through the legislature, the reimbursement cuts will be restored.
For NHPR News, I?m RMD.
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