Connecticut can be a state of vast disparities despite our small size. This is particularly evident in the area of healthcare.
We have some of the best medical training programs in the country, yet Connecticut ranks 47th in retaining the physicians we train in our state. We also have world-class health systems and virtual healthcare deserts in parts of our state with severely underserved areas and populations.
As practicing physicians, nothing is as important as the well-being of our patients and their ability to receive the right care, at the right time, for the right reason, right in their community — or at least close to it.
Medicaid reimbursement rates are the single greatest potential game-changer when it comes to increasing access to healthcare for Connecticut’s underserved population, which is why Connecticut physicians have marshaled an all-out campaign to mobilize action to ease those inequalities.
This legislative session, physicians have been vocal about the need to not just study —but increase — Connecticut’s Medicaid rates, and the Connecticut State Medical Society (CSMS) leadership met recently with various members of the legislative leadership to continue our advocacy on this critical budget matter.
[RELATED: Connecticut is weighing several changes to Medicaid. Here’s a look at some of them]
CT Mirror’s Katy Golvala recently reported on a summit convened by state Comptroller Sean Scanlon to take a serious look at the challenges to healthcare access for low-income residents of Connecticut’s most rural areas. The meeting, held in Storrs at the University of Connecticut, cited factors such as transportation, low staffing levels and other issues that are contributing to the lack of access to quality, affordable healthcare for Connecticut’s underserved areas and people.
The story points out that Connecticut’s Medicaid physician network has been shrinking, largely because Medicaid reimbursements for many physician specialists have been frozen at 57.5% of the 2007 Medicare rates. As Day Kimball Hospital chief executive officer Kyle Kramer said, the result is his hospital loses 40 to 60 cents on the dollar for treating Medicaid patients.
As hard as that dynamic is on a hospital, imagine the burden it places on an independent physician.
Historically, low Medicaid rates have restricted many physicians to limit their participation in Medicaid — prompting Medicaid beneficiaries to seek care in urgent care facilities and emergency departments. This, in turn, increases the cost to the state and doesn’t provide the same level of continued preventative care needed to keep Connecticut patients healthy.
Connecticut’s Medicaid patients should not have to delay or avoid receiving the healthcare they need because they can’t find a physician within a reasonable distance.
Think of it this way: having transportation to a medical appointment is no good if there is no physician to be found. This is why I was heartened to see that the issue of Medicaid rates was on the table at the comptroller’s meeting, as it is in the state budget talks at the capitol. Thankfully, state lawmakers are listening.
The legislature’s Appropriations Committee budget provided for a modest increase to Medicaid rates, which will help expand Connecticut’s Medicaid physician network —and not a moment too soon — because lawmakers are also weighing other bills to broaden Connecticut’s Medicaid coverage to new populations.
If legislators increase the Medicaid population without increasing the capacity of the Medicaid physician network to serve that population, access will suffer even more than it does now.
As president of the state’s largest physician association, I urge Gov. Ned Lamont and legislative leaders to put Connecticut on the path to steadily, if modestly at first, grow our Medicaid rates so that we can rebuild the provider network and begin expanding access to local, cost-effective care.
In the meantime, CSMS is focusing on ways we can spur the recruitment and retention of physicians. Our new CSMS WINS initiative, for example, is tackling the career advancement of women in medicine. Reversing the control of healthcare payment decisions by managed care companies is another way we are working to make Connecticut a more attractive state for physicians to practice.
Connecticut is a small state with daunting healthcare challenges, and we thank Comptroller Scanlon for shining the light on the “healthcare deserts” that exist in Connecticut’s underserved areas and populations.
It’s time to roll up our sleeves, work together to find the solutions, drive progress and make Connecticut a place where both patient AND physician well-being is prioritized and where the best and brightest medical professionals will seek to establish roots and care for all of us. Let’s start by boosting Medicaid rates.
David Hass, MD, is President of the Connecticut State Medical Society.