Don't Let Medicaid Cuts Deter your Eligibility Assistance Efforts

With all the talk of Medicaid expansion under healthcare reform, we sometimes forget that a state’s current economic woes can affect funding for this valuable resource. Such was the case in South Carolina when lawmakers recently repealed a provision in a 2008 law that banned the state’s Department of Health and Human Resources from lowering Medicaid reimbursement levels.

With the new rules in place, South Carolina cut Medicaid rates by three percent for an estimated $7.5 million in savings through the end of the year. Of course, the news left many observers, including hospitals and those currently on Medicaid, wondering how patients in need of this valuable resource would be affected.

Nothing is sacred when it comes to saving money at the state level. Even education funding—states’ largest expenditure—has undergone cuts, yet we remain confident that our schools will find a way to educate all kids in the public school system. Similarly, while we can’t ignore the fact that Medicaid (typically the second most costly line item on state budgets) is more heavily scrutinized during times of economic strain, it is still among the best funding resources for uninsured and indigent populations and is not going away. Concern over declining Medicaid reimbursement rates should not turn into abandonment of robust efforts to assure that eligible individuals are able to access this benefit.

While Medicaid does not reimburse hospitals at the levels of private health insurance, it does cover expenses to a certain degree—and some reimbursement is better than none. With so many hospitals caring for their neediest patients regardless of their ability to pay, healthcare organizations are still wise, financially, to seek coverage for the uninsured. Likewise, patients who receive coverage through hospital assistance benefit by receiving portable health insurance that can help them take charge of their personal care.

Unfortunately, lean times have forced everyone to do more with less.  As such, it’s more important than ever for healthcare organizations to continue screening and assisting patients with the Medicaid enrollment process, not only as a benefit to these individuals, but also as protection for the organization against significant levels of uncompensated care.

Ulrich Brechbühl serves as CEO of Chamberlin Edmonds, an Emdeon company. Atlanta-based Chamberlin Edmonds serves as a patient advocate providing custom-tailored eligibility services to hospitals nationwide.