Physician group opposes governor’s plan to transfer Catamount to Medicaid

The Vermont Medical Society (VMS) formally announced yesterday its opposition to a fiscal year 2012 budget proposal by Governor Peter Shumlin that would allow all Vermonters eligible for Catamount Health Plans to enroll in the state’s Medicaid program.
In opposing the proposed budget, the Society, which represents the state’s physicians, cited numerous adverse impacts the plan would likely have on the delivery of health care in Vermont, including:
* Greatly expanding the pool of Medicaid-eligible residents in Vermont, even to those with high incomes;
* A 32.8-percent cut in reimbursements to physicians treating Catamount Health Plan patients, and in general, putting the financial viability of numerous physician practices at risk;
* An increase in the number of Vermonters with Medicaid but without a doctor in their area who can afford to see them;
* Further shifting costs to employers, making it harder for them to provide health insurance to their employees; and
* Incompatibility of the budget proposal with the goals of the Governor’s health care bill, most notably eliminating the shift of costs between the payers of health services by ensuring reimbursements to health care professionals are sufficient.
Among the most troubling aspects of the plan according to VMS is how Catamount's eligibility criteria, which do not include personal income limits, would allow high-income residents that meet Catamount criteria to enroll in Medicaid.
‘The expansion of Medicaid without regard to income violates the social contract between the state and physicians who have accepted Medicaid’s below cost reimbursement because they wanted to make sure that those in the greatest needed received care,’ said Paula Duncan, M.D., VMS’ president. ‘Increasing the number of Medicaid patients while paying doctors substantially lower than all other payers would be financially devastating to physicians in the state. Many simply wouldn’t be able to afford to keep their doors open to new Medicaid patients.’
Currently, Medicaid reimburses physicians at approximately 79 percent of Medicare and VMS estimates that private insurance companies reimburse Vermont physicians at approximately 125 to 135 percent of Medicare. Greatly expanding the number of patients whose treatments are paid at the 79 percent to Medicare rate would result in millions of dollars in lost revenue for physicians.
Data compiled in 2008 by the Vermont Department of Health suggest that low Medicaid reimbursements have already forced some doctors to restrict the number of Medicaid patients they see. The department’s physician survey showed that while 93 percent of primary care physicians participated in Medicaid, only 69 percent accepted new Medicaid patients compared to 80 percent accepting new patients in general.
‘Doctors dedicate their lives and careers to caring for their patients, but unfortunately they are not immune from economic realities,’ said Duncan. ‘Expanding the Medicaid rolls will no doubt exacerbate the already tough economic situation that many physician practices find themselves in. The end result could be more Vermonters with Medicaid but without a doctor in their area who can afford to see them.’
VMS adopted its formal position by a vote of Council members during a meeting held tonight at various locations using Vermont Interactive Television.
About the Vermont Medical Society: The Vermont Medical Society is the leading voice of physicians in the state and is dedicated to advancing the practice of medicine by advocating on behalf of Vermont's doctors and the patients and communities they care for. Founded more than 200 years ago, the Society has long been recognized as one of the state's most prominent health care organizations. For more information, visit www.VTMD.org.
Montpelier, Vt. (Feb. 9, 2011) ‘