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(NATIONAL REVIEW) – I don’t appreciate being told that I’m not nice. I’m a very nice person. I’m just pissed.” Those were the exasperated words of Aurora, Colo., psychologist Lisa Griffiths directed at “mediators” hired by the Colorado state government to ease tensions over Medicaid reimbursements. The mental-health providers who attended the forum — designed to enable the providers to voice their frustrations to the mediators — want to help low-income patients on Medicaid get the care they need. But they are stymied by a system that is, in the words of the Colorado Sun’s Jennifer Brown, “rife with administrative burdens, convoluted requirements and . . . delays in payment” that make the provision of even the simplest services appallingly complicated. And, sadly, this bureaucratization of government insurance has taken root across the country. It’s time for policy-makers in state capitals and Washington, D.C., to take a long, hard look at Medicaid and implement much-needed reforms.
Health-care-assistance programs such as Medicaid are supposed to be nimble and help vulnerable and low-income people get essential services without financial ruin. That’s difficult, though, when doctors are afraid to accept Medicaid patients for fear of dealing with a sprawling and far from friendly bureaucracy. According to a study released last year by researchers from the University of Chicago, the Federal Reserve Bank of San Francisco, and the U.S. Bureau of Economic Analysis, nearly 20 percent of initial claims submitted to the federal insurer face at least partial rejection. In comparison, only about 5 percent of claims submitted to private insurers were not paid in full.
The study’s authors acknowledge that these figures might not be fully comparable, but the wide disparity highlights the very real complaint of doctors that Medicaid is too complicated with too many middlemen. Sometimes these are managed-care organizations or independent review boards imposing standards on state Medicaid plans, but all of these layers create extra complications for physicians trying to get a simple reimbursement for care rendered.
These issues have led to more than just gripes from already-overworked doctors. Across Illinois, for example, “[doctors’] offices have already closed and the closures have created medical deserts in some of the . . . most vulnerable communities” because of onerous reimbursement procedures. Medicaid complications also impose a tax on some of the nation’s largest health-care providers, ensuring higher costs that are then passed along to taxpayers and other patients in the system.
