Family doctors and OB/GYNs across Georgia could receive a pay increase for caring for patients on Medicaid, which typically pays less than the actual cost of care.
The Senate Appropriations Committee on Wednesday recommended $19.5 million to raise Medicaid reimbursement rates for some primary care services. The addition of federal dollars would up the total increase to about $60 million.
The amount surprised many. Last month, the House had recommended a whittled-back amount of $4.4 million in state funding to pediatricians, OB/GYNs and other primary care doctors.
“This is so needed, this is wonderful,” said Pat Cota, the executive director of the Georgia OB/GYN Society. “We have 40 counties in the state that do not even have OB/GYNs and things were going south fast. I hope this begins to turn things around.”
The extra money aims to at least partially make up for the loss of a Medicaid pay bump funded by the federal government for two years. The bump, called for by the Affordable Care Act, expired at the end of 2014.
Reimbursement for Medicaid, the government health program for the poor, covers, in some cases, only about 40 percent of the amount of what a traditional insurer would pay for an office visit.
The gap in reimbursement causes doctors to lose money in worst cases and to break even in others. As a result, some doctors have stopped taking Medicaid patients altogether.
That has caused problems for thousands of poor Georgians. About 43 percent of Georgia's children are on Medicaid. The problem is most acute in Georgia's rural counties, where Medicaid patients make up nearly 70 percent of some primary care practices. Many doctors have closed shop in these small counties.
The poor are not the only ones hurt by the gap, those in favor of raising the rates said.
The low reimbursement rates are a repellent to residents and other newly practicing doctors, said state Sen. Renee Unterman, R-Buford.
“If they don’t get a positive message from the General Assembly, they’re going to leave, and I don’t blame them,” Unterman said.
Keeping doctors in Georgia, particularly its rural counties, is imperative to stabilizing rural hospitals that are on the verge of collapse, she said.
“If you do not have these gatekeepers, it does no good to stabilize the hospitals,” she said.
The full Senate is expected to vote on its proposed budget, including the Medicaid pay increase, on Friday.
About the Author
