Here's the Mass. Medical Society's reading on how Gov. Patrick's budget cuts will affect health care.
In general, eligibility for care and expanded coverage of the health care reform law will be preserved unscathed.
MassHealth Indemnity, which pays primary care physicians, specialists and all other providers who bill on a fee schedule, is reduced by 3.29%. On a total line item of $1,539,816,000 this cut will contribute $51 million towards the Governor’s goal of reducing spending by nearly a billion dollars.
For Medicaid managed care, the budget is reduced by a similar percentage on total expenditures of $3.1 billion, resulting in savings of $102 million. Although big dollars, these cuts may be deceptively small, since federal matching dollars do not appear. A savings of $150 million to the state will probably require a $300 million reduction in payments to providers.
While some line items, earmarks and past increases were specifically eliminated from the budget, the MassHealth physician raises of the past three years were not. So any proposed reductions at least start from the recent increases. It is unclear exactly how the cuts will be implemented in either the indemnity or the managed care side. Will physician rates be cut? Will they be cut evenly across all specialties? Will other providers suffer larger cuts?
The MMS has participated in discussions with Health and Human Services Secretary Judyann Bigby, M.D., and will continue to do so. Dr. Bigby is well aware of physician hortages in Massachusetts and the need to maintain access to care. She is also aware of the inefficiencies inherent in cutting programs with matching fund eligibility.
Hit hard was the Department of Public Health, with cuts totaling over $28 million. Specifics include:
- Universal immunization programs receive a 12 percent cut on $51.5 million, resulting in $5.9 million in savings.
- The $12.75 million smoking cessation program loses $525,000.
- Disease prevention programs at the DPH lose $1.3 million of their $14.7 million budget.
- Substance abuse treatment and prevention programs cut by $2.8 million.
New initiatives passed recently on workforce development and loan forgiveness are reported to be eliminated completely, but again, details are unclear and we don’t yet know the impact on direct services.
The Board of Registration in Medicine will see a 10% cut, taking $267,000 out of the Board’s state appropriations budget. The Board lives largely on fees, and is uncut in its retained revenue from licensing which is exempt from the budgetary process, and provides an additional $6 to 7 million annually.
These are just a few of the hundreds of programs that have been affected by the downturn in state revenues. The MMS will keep its members apprised of developments and will work to maintain access to critical services and the viability of physician practices.
MMS President Bruce S. Auerbach M.D. told WBZ Radio yesterday that the cuts will accentuate existing problems in the health care system. Read about his comments here.
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