Pretty much everyone on Medicaid here in Texas receives care through a Medicaid Managed Care Program. It’s a big program serving the state’s most vulnerable populations, but there are some big problems. Mostly, there aren’t enough doctors taking part in the program to help serve these populations, and state lawmakers are trying to address that.
As always, step one in finding a legislative solution is to hold a hearing. For this problem, that duty fell to the House Human Services Committee.
“Medicaid Managed Care, as you all know, is now a really big deal in the State of Texas and our job and part of what the speaker wants us to do is to make sure that we make this program as good as possible,” said Democratic Rep. Richard Raymond of Laredo, the committee’s chair.
According to the Texas Medical Association, in 2000 67 percent of physicians were willing to take in new Medicaid patients. In 2014, that number dropped to only 34 percent.
“Most kids in our state get care because of Medicaid. And, so, it’s a critical program from my perspective and for my patients,” said Dr. Ryan Van Ramshorst, a San Antonio pediatrician who testified before the committee.
He says he’s proud to serve Medicaid patients in his community, but Van Ramshorst says the state needs to make getting more doctors to take part in the program a priority. One way to do that, he says, is to pay doctors more for taking those patients.
“We know that Medicaid pays roughly 70 percent of Medicare rates. I have friends that are practicing in San Antonio that either cap their Medicaid population or they don’t take them at all. And, as a pediatrician, I want these kids to be taken care of,” he says.
The program serves more than just the state’s kids. Nursing home and long-term care patients, as well as people with disabilities are also part of managed care. Dennis Borel with the Coalition of Texans with Disabilities told lawmakers they need to revisit the issue of how much they are paying doctors. He says the limits the Legislature set last year aren’t sufficient for the years to come.
“There’s been an erosion of 30 percent of that pay since its high-water mark, so we are way, way behind,” Borel said.
Lawmakers say they’re committed to improving the state’s delivery of health care to the state’s Medicaid population. Last year, the state Legislature passed a bill aimed at holding the insurance companies that run the Medicaid Managed Care program accountable for their network of health care providers.