More Medicaid Reimbursement Woes

Providers of services for children with autism are the latest group to describe the harm caused by the state’s low Medicaid reimbursement rate.

Wisconsin Health News (9/22) includes an interview with Jackie Vick and Mike Miller, the president and treasurer of the newly formed Wisconsin Autism Providers Association.  One of the five goals of the WAPA is to “Increase reimbursement rates for Medicaid treatment.  Low reimbursement rates are the primary cause of client demand exceeding the supply of providers…”

Miller and Vick conducted a survey to see if other providers shared the problem of “putting families in a holding pattern” because of an inability to take more Medicaid clients.  The answer was “yes across the board for all of those providers.”

Miller estimated that over 500 children in the state are waiting for treatment under Medicaid funding.  The lists are growing by 15 to 20 children a week and could total 1,000 by the end of the year.

Vick said that providers have responded to the challenges of the reimbursement rate in different ways.  Some limited the number of Medicaid clients in order to maintain fiscal stability.  A related problem, she said, is the difficulty of hiring therapists and technicians because of the low rate of pay.

She pointed out that access to treatment for young children pays off for them and for  taxpayers.  Vick said, “…the research shows that they make great gains and the lifetime costs of care for a child on the autism spectrum go down.”

The low Medicaid rate affects children with other behavioral health problems.  Here is an excerpt from the Kids in Crisis/Legislative Action Tracker article that was part of a series by USA Today-Wisconsin (June 2016)

There is evidence that Wisconsin’s Medicaid reimbursement rates – among the lowest in the country – are shutting children out of accessing outpatient behavioral health care and leading to higher costs associated with emergency psychiatric care.

A report by Milwaukee’s Public Policy Forum found that in Milwaukee County, low reimbursement rates were stopping mental health providers from accepting Medicaid patients. A 2014 survey by the Wisconsin Statewide Medical Home Initiative found that only 20 percent of Wisconsin pediatricians said they could find therapists when needed for their patients on Medicaid, and just 5 percent could find psychiatrists for patients on Medicaid.

Check out “Voices from the Front Lines: NAMI’s Lindsay Wallace” on this blog for a report on how people with mental illness in Dane County are affected by the rate.

Click here to read a study by Pew Trusts that reports experiences of states that supplemented Medicaid rates for primary care doctors.

 

 

 

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