Monday, September 17, 2012

Combination of Cuts Squeezing Valley Physicians, Patients

Carlos Cardenas, MD, vice chair of the Texas Medical Association Board of Trustees and TMA’s Border Health Caucus, told House Committee on Human Services members today that physicians in the Texas border region cannot keep caring for patients without immediate action by lawmakers to lessen payment cuts that went into effect in January. Texas Medicaid implemented a new policy limiting what it pays physicians who treat dual-eligible patients. As a result, physicians across the state who care for these patients have been forced to absorb a cut of 20 percent, and in some cases, even more.

“Dual-eligible” patients are low-income seniors and people with disabilities who qualify for both Medicare and Medicaid. In Texas, there are almost 465,000 dual-eligible patients who are among the sickest and most vulnerable people in our state. Many reside in nursing homes.

“Without physicians in communities across this region providing the right care, at the right time, and in the right manner, border health disparities and long-term health cost will rise by an exponential factor,” said Dr. Cardenas, a practicing gastroenterologist in McAllen.

“Over the past year, South Texas physicians and providers have experienced one of the most challenging periods of change in modern time,” he said. The Texas Medicaid program expanded Medicaid managed care for women, children, and seniors into South Texas. Simultaneously, the state reduced payments for Medicaid-eligible, low-income seniors through revisions to its dual-eligible payment policy, while changes by the federal government to the Health Professional Shortage Area program went into effect and led to the loss of additional payments for most urban counties in South Texas. These factors contribute to the growing health care crisis in Texas’ border region — a region already burdened by high rates of chronic health conditions, illiteracy, and uninsured individuals.

“Physicians already have begun exiting the South Texas community,” Dr. Cardenas warned lawmakers. “Relief for these physicians and their patients cannot happen too soon.”

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