In the lead-up to the state’s transition of the Medicaid program from a fee-for-service model to managed care, Iowa’s physicians raised concerns about continuity of care for patients and the administrative burden of navigating three Medicaid managed care plans, but nonetheless most physicians joined the managed care plans’ provider networks in good faith. Four months later, not only are our original concerns being validated but Gov. Terry Branstad also has given the Department of Human Services authorization to implement $30 million in Medicaid cuts largely targeted at Iowa physicians.
Medicaid cuts have consequences. When the state implemented a 5 percent across-the-board rate cut in 2009, reduced payments forced some physicians to limit appointments for Medicaid patients, or to stop accepting new Medicaid patients altogether.
The average cost of operating a medical practice has risen more than 27 percent in the past decade, but Iowa’s Medicaid payment rates today are virtually unchanged from those paid in the year 2000. Despite this, Iowa physicians remain committed to helping ensure vulnerable Iowans have access to the care they need. Cutting already insufficient Medicaid rates will exacerbate administrative issues and threaten access to care for Iowa’s Medicaid beneficiaries over the long term.
On behalf of the more than 6,300 physician, resident, and medical student members of the Iowa Medical Society, I urge Gov. Branstad and DHS not to turn their backs on Iowa physicians and our patients. Do not implement cuts to Medicaid physician rates, and do not limit patients’ access to care.
Joyce Vista-Wayne, MD, DFAPA
President-Elect, Iowa Medical Society