Friday, February 24, 2012

Doctors: Illinois Medicaid crisis to get worse | Feb 24, 2012

By CHRIS CASHMAN - Northwest Herald

Doctors are howling over Gov. Pat Quinn’s plan to cut Medicaid spending by $2.7 billion next year. There are fears that cuts could lead to more McHenry County doctors refusing to treat Medicaid patients and an exodus of doctors to other states.

In his annual budget address this week, Quinn said reductions could be accomplished by cutting payments to doctors and hospitals, halting some services and restricting eligibility for the program.

He said Medicaid, which provides care for 2.7 million people in Illinois, “is on the brink of collapse.”

Dr. Paul DeHaan of Crystal Lake, an orthopedic surgeon with Mercy Health System in McHenry, said Medicaid already is in crisis, and that Quinn’s plan will make things worse.

“Access for Medicaid patients to get in to see a doctor is limited,” DeHaan said. “There are only a small number of practices that will accept new Medicaid patients. Too many doctors won’t or can’t see new Medicaid patients.”

“Private practices are small businesses, just like any small business,” DeHaan added. “They’re strangling under the financial burden of the Medicaid system as it already exists.”

DeHaan, who was in private practice in McHenry for 20 years before joining Mercy Health System six years ago, said Medicaid payments are less than the cost of providing services.

And health-care providers are paid “very, very late. It creates a cash-flow problem for doctors. They cannot make a profit.”

“This makes it necessary to increase the cost to other patients with medical insurance to defray the cost of Medicaid shortfalls,” DeHaan said. “Doctors are losing money seeing Medicaid patients.”

The result is that Medicaid-eligible patients call doctor after doctor, unable to find care.

“And this is the current situation,” DeHaan said. “When Gov. Quinn cuts funding, it’s going to get even worse.”

According to the Illinois State Medical Society, half of physicians who train in Illinois leave the state after residency.

“If we are in a situation where health-care economics get even worse, we’re going to lose even more talent from our remarkable medical schools,” DeHaan said. “Should reimbursements fall even further, they would be foolish to stay in Illinois. They could go to other states and be much better off economically.”

The number of Medicaid enrollees in McHenry County has risen 103 percent since 2005, while increasing 30 percent statewide, said Robert Rosenberger, executive vice president and chief financial officer for Centegra Health System. The system operates two hospitals and multiple other facilities in McHenry County.

“That shows that there are a whole lot more people to go on the Medicaid rolls,” Rosenberger said.

“Gov. Quinn offered no specifics on how to save $2.7 billion,” Rosenberger said. “So it’s hard to say how it will impact the hospital.”

He said 15 percent to 16 percent of the patients Centegra doctors see are on Medicaid.

“Independent physicians may cap it at 1 [percent] or 2 percent, he said.

The state owes Centegra $6 million this fiscal year – and $10 million total – in Medicaid payments.

“We’re very strong from a financial standpoint,” Rosenberger said. “That helps us absorb some of the blows from Medicaid.

“Health-care providers need to find a way to decrease costs while increasing quality,” Rosenberger said. “That’s health-care reform.”

For Dr. Steve Campau, who practices general medicine in Mercy’s Algonquin office, the Medicaid crisis is a “community problem.”

“Medicaid is the last resort of people who have been thrown away from every segment of society: employers, insurers, their family,” Campau said. “Nobody wants to be responsible.”

“It’s the end result of misplanning and abdication of responsibilities,” he said. “Promises that have been made have far exceeded the resources that have been allocated for them.”

What is Medicaid?

Medicaid provides health coverage to more than 50 million children, families, pregnant women, the elderly, and people with disabilities.

All states provide Medicaid to infants and children under age 6 with family incomes up to 133 percent of the federal poverty level, or FPL, ($29,725 for a family of four in 2011). Medicaid is available in every state for children under age 19 with family incomes up to $22,350 (100 percent FPL). Medicaid covers U.S. citizens and eligible immigrants.

Source: InsureKidsNow.gov

# http://www.nwherald.com/2012/02/23/doctors-medicaid-crisis-to-get-worse/aqeihrx/

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