Free Daily Headlines :

  • COVID-19
  • Money
  • Election 2020
  • Politics
  • Education
  • Health
  • Justice
  • More
    • Environment
    • Economic Development
    • Gaming
    • Investigations
    • Social Services
    • TRANSPORTATION
  • Opinion
    • CT Viewpoints
    • CT Artpoints
DONATE
Reflecting Connecticut’s Reality.
    COVID-19
    Money
    Election 2020
    Politics
    Education
    Health
    Justice
    More
    Environment
    Economic Development
    Gaming
    Investigations
    Social Services
    TRANSPORTATION
    Opinion
    CT Viewpoints
    CT Artpoints

LET�S GET SOCIAL

Show your love for great stories and out standing journalism

New Medicaid patients could test state’s physician network

  • Health
  • by Keith M. Phaneuf
  • July 16, 2010
  • View as "Clean Read" "Exit Clean Read"

Connecticut stands to see its Medicaid patient caseload surge starting in 2014 as national health care legislation opens the door to as many as 150,000 new patients over a six-year period, according to a new study.

And while there would be new federal funding to cover much of the added cost, there’s no guarantee that patients will be able to find doctors unless state government moves now to reverse a dangerous shortage in primary care providers, health care advocates and one key state lawmaker said Thursday

“Our provider networks are simply not large enough to handle it,” said Ellen Andrews, executive director of The Connecticut Health Policy Project, a New Haven-based, nonprofit health care advocacy group. “Doctors are going to get inundated with phone calls and many people are not going to have access to health care unless we act now. You can’t grow doctors overnight.”

Andrews was reacting to a recent analysis of the federal Patient Protection and Affordable Care Act adopted in May, which opens Medicaid-funded state health coverage to single, childless adults who earn less than 133 percent of the federal poverty level. According to the Center on Medicare and Medicaid Services, that would mean an individual earning less than $14,403 this year.

The analysis prepared by The Urban Institute, a Washington, D.C.-based, nonpartisan economic and social policy research group, estimated Connecticut’s annual Medicaid caseload would grow – solely due to new enrollees eligible because of this legislation – between 114,083 and 154,664.

Much of this growth would appear in 2014, when the new requirement takes effect, and would be fully realized by 2019.

Those growth numbers represent a range between 22 and 30 percent of the current Medicaid-funded health care caseload, excluding elderly patients in nursing homes.

According to state Department of Social Services spokesman David Dearborn, Connecticut provides health care to about 249,000 children and 130,000 adults through the Medicaid-funded portion of the Husky program. Nearly 45,000 unemployed, single adults without children receive health benefits through General Assistance. And another 90,000 disabled and low-income elderly residents receive assistance through what is commonly called the “fee for service” system, one of the oldest state Medicaid programs that reimburse physicians based on each treatment or service they provide.

Connecticut’s network of primary care physicians – pediatricians, family practitioners and internists – already is stretched to its limit, Andrews said, adding that was badly exposed in 2008 when Gov. M. Jodi Rell’s Charter Oak Health Program – a state-funded program that provides health coverage to poor adults at group rates – was launched. Insurance companies competing to administer Charter Oak and Husky struggled to find a sufficient number of doctors willing to treat patients from these two programs.

The Connecticut State Medical Society, the state’s largest physicians’ organization with more than 7,300 members, released a workforce study last year that argued Connecticut’s primary-care capacity was stretched thin.

The report found 74 percent of family practitioners and 72 percent of internists in Connecticut were accepting new patients.

But it also found wide variances in access to primary care physicians on a county-by county basis. The percentage of all primary care physicians accepting new patients in Windham and Tolland counties was just 37.5 percent and 50 percent, respectively, while in Fairfield and New London counties it was 85 and 87 percent.

Audrey Honig Geragosian, spokeswoman for the society and one of the authors of the 2009 study, agreed with Andrews that Connecticut has a relatively short time frame to prepare for a huge influx of patients. “Guaranteeing health coverage is not the same as providing access to care,” she said.

The state legislature and Rell approved a series of rate increases in 2007 for physicians who treat Medicaid patients, but many of the categories that received increases had not been adjusted in more than a decade.

Geragosian also said reimbursement rates, though important, are just one consideration.

Doctors remain wary of Connecticut, she said, because state officials have largely ignored a distorted medical malpractice system that has resulted in some of the highest insurance premiums in the country.

And with about 86 percent of this state’s physicians in small practices with four members or fewer, the high cost is too burdensome for many, Geragosian said. “Imagine you are a small business and every year you have to shell out tens of thousands of dollars before you can see a single patient,” she added. “Connecticut remains one of the crisis states in terms of medical malpractice. We’ve got a reputation.”

The medical society also remains concerned about the ongoing consolidation of the health insurance industry, a trend that leaves doctors with fewer and fewer insurance networks to negotiate with, Geragosian said. That lack of competition gives companies considerable leverage to pay rates that are not competitive with those available outside of Connecticut, particularly given the higher cost of doing business here, she said.

State Sen. Jonathan Harris, D-West Hartford, co-chairman of the legislature’s Public Health Committee, said that in addition to addressing factors that weaken Connecticut’s competitive edge in attracting and retaining doctors, the state needs to act now to begin producing more primary care physicians from its universities and colleges.

That should mean new financial incentives being offered, but not just to students, Harris said.

Though tuition waivers and low-interest loans for students are a good idea, “we have to take a look outside of the box and look at putting requirements on our medical schools themselves,” Harris said.

The West Hartford lawmaker said he’s open to exploring offering the University of Connecticut Health Center in Farmington added funding if it graduates more pediatricians, family practitioners and internists. That could require the center to overhaul its curriculum, develop other programs to attract medical students interested in this type of practice, and even begin screening applications more closely to target the right applicants.

“If they can’t grow these doctors that we need, then they might lose out on some funding,” Harris said. “This is the type of problem that if you don’t get your arms around it soon, then later you’re definitely going to be behind the eight ball.”

Sign up for CT Mirror's free daily news summary.

Free to Read. Not Free to Produce.

The Connecticut Mirror is a nonprofit newsroom. 90% of our revenue comes from people like you. If you value our reporting please consider making a donation. You'll enjoy reading CT Mirror even more knowing you helped make it happen.

YES, I'LL DONATE TODAY

ABOUT THE AUTHOR

Keith M. Phaneuf

SEE WHAT READERS SAID

RELATED STORIES
For some transgender people, pandemic paves path to transition
by Carol Leonetti Dannhauser | C-HIT.ORG

The COVID-19 pandemic has given many transgender individuals the incentive to begin gender-affirming hormone therapy.

COVID deaths and infections in CT nursing homes decline as more residents are vaccinated
by Dave Altimari

There were 85 deaths in nursing homes and 312 residents infected during the week ending Jan. 12.

COVID lawsuit against CVH and Whiting hospitals dismissed
by Kelan Lyons

With vaccines for patients on the horizon, plaintiffs agreed to the case's dismissal.

Democrats eye tax on insurers to fund broader health reform package
by Jenna Carlesso

Lawmakers want to revive a tax on carriers to support additional subsidies on the exchange, expansion of Medicaid.

CT seniors age 75 and older can register for the COVID vaccine next week
by Keith M. Phaneuf

Hospitals will lead a series of regional outreach programs to sign up elderly residents who don't live in nursing homes.

Support Our Work

Show your love for great stories and outstanding journalism.

$
Select One
  • Monthly
  • Yearly
  • Once
Artpoint painter
CT ViewpointsCT Artpoints
Opinion The struggle for racial justice and equality is far from over
by Marilyn Moore

On the eve of the annual celebration of Dr. Martin Luther King, Jr.’s birthday, I and many others are reflecting on what recently transpired at the U. S. Capitol and how it relates to the injustices that Dr. King and so many others fought to change so many years ago. It is obvious that our nation's fight for racial justice and equality is far from over. In fact, it continues to this day.

Opinion The mentoring circle: Supportive relationships across generations
by Josiah H. Brown

January is Mentoring Month, January 17 International Mentoring Day — with the Martin Luther King Jr. holiday a day of service. 

Opinion Evidence not clear that Trump incited Capitol destruction
by Alan Calandro

Defending President Donald Trump is not popular and I have no interest in writing this other than adherence to truth. Recognizing the truth (if we can find it, which is not always possible of course) should make us be able to come together around that and move on with a common understanding.

Opinion Securing our nuclear legacy: An open letter to President-elect Joe Biden
by Erik Assadourian

Dear President-elect Biden: As you noted in a tweet shortly after protestors stormed the Capitol on Wednesday, “Today is a reminder, a painful one, that democracy is fragile.” Indeed it is. And so are nation-states.

Artwork Grand guidance
by Anne:Gogh

In a world of systemic oppression aimed towards those of darker skintones – representation matters. We are more than our equity elusive environments, more than numbers in a prison and much more than victims of societal dispositions. This piece depicts a melanated young man draped in a cape ascending high above multiple forms of oppression. […]

Artwork Shea
by Anthony Valentine

Shea is a story about race and social inequalities that plague America. It is a narrative that prompts the question, “Do you know what it’s like to wake up in new skin?”

Artwork The Declaration of Human Rights
by Andres Chaparro

Through my artwork I strive to create an example of ideas that reflect my desire to raise social consciousness, and cultural awareness. Jazz music is the catalyst to all my work, and plays a major influence in each piece of work.”

Artwork ‘A thing of beauty. Destroy it forever’
by Richard DiCarlo | Derby

During times like these it’s often fun to revisit something familiar and approach things with a different slant. I have been taking some Pop culture and Art masterpieces and applying the vintage 1960’s and 70’s classic figures (Fisher Price, little people) to the make an amusing pieces. Here is my homage to Fisher -Price, Yellow […]

Twitter Feed
A Twitter List by CTMirror

Engage

  • Reflections Tickets & Sponsorships
  • Events
  • Donate
  • Newsletter Sign-Up
  • Submit to Viewpoints
  • Submit to ArtPoints
  • Economic Indicator Dashboard
  • Speaking Engagements
  • Commenting Guidelines
  • Legal Notices
  • Contact Us

About

  • About CT Mirror
  • Announcements
  • Board
  • Staff
  • Sponsors and Funders
  • Donors
  • Friends of CT Mirror
  • History
  • Financial
  • Policies
  • Strategic Plan

Opportunity

  • Advertising and Sponsorship
  • Speaking Engagements
  • Use of Photography
  • Work for Us

Go Deeper

  • Steady Habits Podcast
  • Economic Indicator Dashboard
  • Five Things

The Connecticut News Project, Inc. 1049 Asylum Avenue, Hartford, CT 06105. Phone: 860-218-6380

© Copyright 2021, The Connecticut News Project. All Rights Reserved. Website by Web Publisher PRO