Hospitals and physicians in Mississippi have differing perspectives on Gov. Haley Barbours plan to fund shortfalls in the Medicaid program.
Hospitals are upset with the plan, saying the governor is trying to shift the burden of paying for Medicaid by increasing a form of hospital tax called the gross revenue assessment, but doctors are relieved that a proposed $17 million cut in their reimbursements will not go through.
Barbours plan calls for a $370 million reduction in inpatient hospital-reimbursement rates while distributing about that same amount to hospitals through another pool of Medicaid money under federal upper-payment-limit provisions, which are designed to help hospitals defray the cost of caring for the poor. In addition, the state will increase the gross revenue assessment from its current 0.45% to 1.08%. The state is enacting this plan because it has to find
$90 million to make up its share in Medicaid dollars. Increasing the tax will pay for about $88 million of that, with another $2 million generated by cutting some services.
Questions remain on how the governors plan will work, according to Sam Cameron, president and chief executive officer of the Mississippi Hospital Association. It is unclear how individual hospitals will be affected by the upper-payment-limit provision, he said, adding that some facilities will come out winners and others as losers through that form of reimbursement.
The hospital association was not involved in any of the discussions for the new plan, he said. At this point we have no faith in anything the governors office says.
But physicians in the state say hospitals agreed to the tax in 2001 as a way to offset costs. The increase to the gross revenue assessment is nothing more onerous than anything they agreed to in the last seven years, said J. Patrick Barrett, a physician and president of the Mississippi State Medical Association.
But doctors arent thrilled with the plan. Even though reimbursement levels to physicians are unaffected by the governors plan, its only a stop-gap measure, not a plan that addresses the issue of adequately funding Medicaid so that doctors can care for beneficiaries, Bennett said.
Originally Barbour, who was fighting with the state Legislature on how to solve the deficit, wanted to cut $365 million from the program. A House bill was in the works to stop the cuts, slated to go into effect Aug. 1, but the governor said he instead decided to develop a plan under a law requiring him to order cost-containment measures if a Medicaid deficit is imminent.
Mississippi expects to implement the plan Sept. 1, pending final approval from the CMS and a mandatory 25-day period in which providers can request a hearing to review the plan, according to a spokesman for the governor. Barbour and the Legislature had reached a stalemate on how to cover the Medicaid deficit, but the new plan requires no legislative action, the spokesman said.