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SOURCE Washington State Medical Association
Washington State Medical Association (WSMA) focuses on ensuring access to care at time of influx of patients and possible physician shortages
OLYMPIA, Wash., Feb. 11, 2014 /PRNewswire-USNewswire/ -- Governor Jay Inslee shared his health care priorities with more than 150 physicians at the 2014 Legislative Summit of the Washington State Medical Association (WSMA) on Monday, February 10. Physicians from throughout the state gathered in Olympia to hear the Governor speak, along with Representative Matt Manweller (R) of the House Health Care and Wellness Committee and Senator Andy Hill (R), chair of the Senate Ways and Means Committee.
"We were happy to hear Governor Inslee talk about the importance of having enough physicians and health care providers to deliver care now that we have more people with insurance," said Dale Reisner, MD, president of the WSMA. "We were encouraged by his willingness to work with the health care community to address capacity issues, such as possible physician shortages and the business challenges of seeing Medicaid patients."
"We're going to be looking closely at payment levels for doctors taking Medicaid patients," said Governor Inslee. "We know we did the right thing when I was in Congress of increasing the Medicaid reimbursements for primary care docs, but now that federal support is coming to an end. We want to continue trying to deal with that problem."
Physicians attending the Summit met with their legislators to talk about WSMA's priority legislation for the 2014 session. The four key issues on which the WSMA is advocating include:
Maintain fair Medicaid compensation for primary care physicians – The Affordable Care Act increased reimbursement for primary care services. However, the 100% federal funding ends in December while the state's fiscal year doesn't begin until July 2015, leaving a six-month gap in the current supplemental budget. Closing this funding gap will help ensure that patients can continue to see their physicians and will encourage physicians who have limited the number of Medicaid patients they will treat because of funding uncertainty to reconsider that decision.
Increasing capacity to see Medicaid patients is critical because demand for care is increasing throughout the state as Medicaid expansion brings more patients into the system. The WSMA is part of a coalition of health care providers and organizations asking for that funding to be continued during the six-month gap.
Graduate medical education (GME) funding – Washington needs more physicians-especially as we are experiencing a great influx of patients into the system due to health care reform. Since 2009, 25% of funding for GME has been cut. The WSMA would like that funding restored to encourage more physician training. This directly impacts access to care.
Addressing health benefit exchange patients in grace periods. – A little-known provision of the Affordable Care Act established a 90-day "grace period" during which physician practices could be held responsible for care delivered after the first 30 days when a patient does not pay their insurance premium. Under the current law, patients enrolled in a qualified health plan (QHP) through the health benefit exchange and who have fallen behind on premiums can retain insurance coverage. Insurance companies are responsible for reimbursement for the first 30 days of the grace period but physician practices could be responsible for absorbing the cost of all claims during the following 60 days-without knowing which patients are in the grace period. The WSMA would like to require insurers to provide timely notice of a patient's status with regard to the grace period.
"The uncertainty surrounding reimbursement for claims during the grace period could have a chilling effect on the willingness of physicians to serve exchange patients, which would undermine the effect of the exchange," said Dr. Reisner.
Ensuring access to health services through telemedicine – Telemedicine can improve access to health services leading to significant improvements in medical care outcomes. Telemedicine is a cost-effective and efficient way of delivering care, particularly in rural communities. It will help meet the challenges of provider shortages by using clinicians' time more efficiently. The WSMA seeks reimbursement for physician services provided via telemedicine.
"In addition to these four key issues, we are also working to address network adequacy, to ensure enough physicians are participating in the plans offered by the exchange, transparency and an all-payer claims database, and providing free blood testing for Good Samaritans who respond to medical emergencies."
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