Forum Discusses How Expansion of Medicaid Will Affect Physicians
Date: 07-03-2013
[MMA News Now, March 7, 2013] In the wake of the Legislature’s vote to expand Medical Assistance in accordance with the Affordable Care Act, many physicians who deal with Medicaid patients are worried about how they are going to handle the increase.
Danielle Robertshaw, M.D., medical director with Health Care for the Homeless, discussed working with patients who have complex medical as well as social needs. A group of physicians and health care leaders gathered in Minneapolis on March 6 to discuss this and other issues regarding the future of Minnesota’s public programs in the first of a series of policy forums hosted by the MMA.
In February, the Legislature voted to expand Medical Assistance to those earning up to 138 percent of the federal poverty level. This means that approximately 34,000 previously uninsured, low-income Minnesotans will have access to health care coverage. An additional 53,000 individuals currently covered by MinnesotaCare will shift to the Medical Assistance program.
These numbers worry the group, according to a poll taken at the forum by the MMA. While 89 percent of the forum attendees support the expansion of Medical Assistance, 80 percent were worried about the state’s primary care physicians’ capacity to serve the new Medicaid patients.
Two attendees are well versed in working with patients who are unable to pay for care.
Paul Johnson, M.D., medical director for HCMC Coordinated Care Center, which he referred to as an “ambulatory ICU,” said the center’s patients are all on Medical Assistance; many are homeless and suffer from mental illness. Yet, Johnson’s staff sees great results. For example, he noted that the care provided by the center has led to a 40 percent reduction in emergency room admissions. “Our patient satisfaction scores are off the chart,” he said.
Danielle Robertshaw, M.D., who works with Johnson and is the medical director at the HCMC Health Care for the Homeless program, said her colleagues need to deal with more than just a patient’s health care. “A majority of our patients have complex medical needs but they also have these complex social needs,” she said.
Despite these concerns, those in attendance agreed that physicians have an ethical obligation to see these patients even if they are not compensated fairly to do so.
Peter Wold, M.D., of St. Paul Radiology PA, noted that in his specialty he never knows whether a patient has good insurance or any at all. “We just want to help,” he said.
Still, not being fairly compensated can be frustrating. “I don’t think the public knows how much free care physicians have given over the last 10 or 20 years,” noted Carl E. Burkland, M.D., of Parkview Medical Clinic in New Prague.
The event was the first of several policy forums that the MMA is planning in 2013. Future topics include: prescription opioid addiction, abuse and diversion; prior authorization of prescription drugs; primary care physician workforce capacity and Minnesota’s quality measurement agenda.
The forums aim to bring physicians together to discuss important issues affecting the practice of medicine in Minnesota; facilitate physician input through open, accessible an inclusive formats and locations and educate, debate and influence MMA policy positions.
Stay tuned to MMA News Now for details on the next policy forum.
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