New Medicaid cuts that impact doctors in South Carolina took effect Monday.
The state will be trimming how much it reimburses doctors to treat Medicaid patients, with some doctors seeing cuts of up to 7 percent. The cuts are in addition to an across-the-board 3 percent cut that began in April. It also raises the patient co-pay by a dollar, to $3.20.
Tony Keck leads the state’s Medicaid agency, the Department of Health and Human Services. He says the cuts are necessary to save $125 million at an agency that ran more than $220 million in deficits last year, “When we’re trying to figure out how to spend the state’s tax dollars, we’ve got to make value judgments about what’s in the health care system that we want to pay for. Where’s the state going to get the biggest bang for its buck?”
Primary care doctors and pediatricians will see a 2 percent cut, as well as dentists. Chiropractors, psychologists and podiatrists are among those that will see the highest cuts at 7 percent. The new plan was originally announced in June.
However, many physicians are worried the change would make it too costly for them to accept Medicaid patients. “We’re extremely concerned about the ability to continue to make ends meet for our Medicaid patients,” said Gregory Tarasidis, the past president of the South Carolina Medical Association, “What none of us want, but we’re being forced to do, is make business decisions instead of just doing what we want… practice the profession of medicine.”
Keck said South Carolina is in the process of changing how it pays doctors to treat patients, moving away from paying for specific services (the so-called “fee-for-service” system) and trying to incentivize coordination of care. “We have to get providers off of this hamster wheel, where they just have to do more, more, and more to keep up,” Keck said, “We’ve got to figure out a way… about how to pay providers for the value they deliver and then reward them for that value.”
17 South Carolina hospitals– especially those in poor, rural areas– were exempted from the cuts. (See a list of the hospitals exempted)
Keck said hospitals need to move towards coordinated care in the coming decades to keep health care costs down, “Right now, we pass (Medicaid) patients in between lots of different parts of the provider system. They’re all incentivized differently. All of their measures of success are different and there’s a lot of inefficiency in there.”
He said Medicaid patients also need to play a bigger role in their treatment in order to save the system additional money. He said those receiving Medicaid-funded treatments need to think more like consumers.