Monday, September 18, 2017

Medicaid Targets Physicians Offering Low Cost Options for Patients

The medical practice I began using in 2010 set up a discount plan to provide better care for patients and to help them save money, especially those customers without insurance. I pay a fixed monthly fee to be a member. That membership allows me to go in for any service offered, including yearly physical examinations, mammograms, pap tests, immunizations, blood tests, X-rays, casts for broken limbs, even minor surgery, for less than $30 a visit. The practice hired extra medical professionals, such as a psychologist and a physical therapist, to meet a wide variety of needs. They also provide extended hours.

As the saying goes, however, "No good deed goes unpunished." Two days ago, the state made sudden rule changes affecting Medicaid patients who are not participants of the discount membership at their practice or any others with similar affordable plans. Medicaid allegedly claims these clinics are offering health insurance.

As a result, the state refuses to reimburse such clinics for many medical services rendered to their Medicaid patients, even long-established ones. Need immunizations? Go to the health department. Blood work? Go elsewhere for a draw. Sick after hours? Go to one of the few Medicaid-approved clinics or the ED (Emergency Department). This is a special hardship for sick, elderly, or disabled patients who must go to different locations for tests offered on site by their chosen physicians.

My current health provider offers the best care I remember receiving in my many adult years. The practice tries to help patients falling between the cracks of our increasingly inefficient health care system. These individuals don't have employer-based coverage and can't possibly pay the ACA's high premiums and deductibles.

Yet the government allegedly targets these clinics with innovative plans to meet customer needs, including those of their Medicaid patients. Is it any wonder that many more physicians and facilities are refusing Medicaid patients?

Why punish low-income patients eligible for Medicaid coverage and the shrinking numbers of caring, competent providers still willing to accept them as patients? Why shouldn't individuals be allowed to purchase discount plans? The clinic memberships and co-pays are drastically less expensive than the skyrocketing deductibles of coverage they can't otherwise afford.

I want to do just that - buy into Medicaid for catastrophic care, and keep my doctor (remember that promise?) and clinic discount plan. I would only use Medicaid for any needed surgeries, hospital stays, or dental and vision care exceeding cost limits. Why shouldn't patients be allowed to make such decisions? Is it because they make common sense?

Across the state, Colorado physicians and clinics have designed flexible, affordable discount plans for low-income patients. Many of those same practices want to continue serving those with Medicaid coverage. The state's inexplicable overreach will not only penalize those patients and providers. It will drive more qualified physicians and clinics from accepting Medicaid customers at all.

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