California Health: Cuts to Medi-Cal Threaten Access to Care

Employees fill orders at a specialty pharmacy operated by ModernHealth in North Hollywood. Sherri Cherman, ModernHealth’s president and chief operating officer, says if state officials impose a 10 percent cut next year, the company will have to drop out of the Medi-Cal network. Photo: Chris Richard

Employees fill orders at a specialty pharmacy operated by ModernHealth in North Hollywood. Sherri Cherman, ModernHealth’s president and chief operating officer, says if state officials impose a 10 percent cut next year, the company will have to drop out of the Medi-Cal network.
Photo: Chris Richard

By Chris Richard

Medi-Cal, the Medicaid program for 8.5 million impoverished Californians, will greatly expand with the implementation of the Affordable Care Act next year.

But even as the state Department of Health Care Services prepares to accept an estimated 1.1 million newly-eligible people into the program, California is reducing its payments to many doctors and pharmacies by at least 10 percent.

That’s bringing warnings it may be increasingly difficult to find health-care providers willing to serve Medi-Cal patients.

Mark Dressner, president of the California Academy of Family Physicians, noted that health-care reform is expected to bring a surge of new patients across the board.

“If you as a physician have a choice, are you going to take new patients who are insured through Covered California – and there’s going to be millions of them – or are you going to take new Medi-Cal patients where you are going to be making less than anyone else taking Medicaid in the United States?” he asked.

According to a study by the nonpartisan California Budget Project, California physicians received just 51 percent of what Medicare paid for the same services last year. Only doctors in Rhode Island and New Jersey received less.

Some 57 percent of California physicians accepted new Medi-Cal patients in 2011, the second-lowest rate after New Jersey, the CBP reported.

The new reductions arise from the clash between Gov. Jerry Brown and state legislators over balancing California’s budget in 2011.

That year, the state government faced a $26 billion deficit. Brown sought to make up part of the difference by extending expiring fees and taxes, but Republican legislators balked. So Brown cut $10 billion in spending, including Medi-Cal reimbursements.

Continue reading here: http://www.healthycal.org/archives/13788

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