Medicaid physicians earn pay bump

By Michael Schroeder
The Journal Gazette

For the first time in nearly 14 years, Medicaid providers in Indiana are getting a raise.

About 5,000 primary-care physicians across the state will receive bonus payments totaling $39 million for fiscal years 2007 and 2008. (The state’s fiscal year runs from July 1 to June 30.) As of Jan. 1, the program also increased rates for certain services, totaling $32 million annually, focusing on primary and preventive care.

The bonuses, some of which have already been issued, and the increases are to reward current physicians caring for Medicaid patients and attract others into the program’s network, said Dr. Jeffrey M. Wells, director of Indiana Medicaid.

He outlined Medicaid changes Friday at Fort Wayne Medical Education Program headquarters on Lake Avenue.

About 40 percent of patients at the medical education program’s family practice clinic are covered by Medicaid. The clinic wouldn’t be able to keep its lights on without financial support from local hospitals, said Dr. Brenda O’Hara, the medical education program’s president and CEO.

Lagging reimbursement rates have scared many other providers away from contracting with Medicaid, which insures low-income patients and those with long-term care needs, among others.

Most specialists and many primary-care doctors restrict the number of Medicaid patients they see, O’Hara said. She hopes the rate increases improve physician participation and give more options for Medicaid patients.

The rate increases are part of the Indiana Check-Up-Plan that passed the Indiana General Assembly during the 2007 legislative session. Those increases will average about 25 percent for targeted services – certain evaluation and management procedures, early periodic screening diagnosis and treatment, and scheduled weekend and holiday services performed by primary-care physicians and specialists performing preventive care.

The plan is to pay doctors more upfront to control long-term health care costs and improve care.

“Effective use of primary and preventive care is vital to our goal of moving toward a value-driven system,� Indiana Family and Social Services Administration Secretary Mitch Roob said in a statement. He said “the focus is on improving members’ outcomes while tackling growing healthcare costs.�
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