Utah doctors knock Medicaid

Thursday , July 18, 2013 - 5:57 PM

Medicaid Doctors

In this July 3, 2013 photo, Dr. Jason Horgesheimer DDS poses at Granger Pediatric Dentistry in West...

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SALT LAKE CITY — Fewer Utah doctors are willing to care for a growing number of Medicaid patients, according to analysts at the Utah Legislature.

The latest figures show the number of Utah medical providers willing to take Medicaid patients has dwindled to 2,517, down by 25 percent from 3,366 in 2008.Doctors blame low reimbursement rates and the hassle of paperwork. They told a legislative committee it’s hard to get the federal and state program to approve some procedures and surgeries.

The number of people in Utah on Medicaid, meanwhile, has grown by nearly 30 percent to nearly 380,000 since 2008.

The Salt Lake Tribune first reported the figures. They were collected by Russell Frandsen, a fiscal analyst for the Utah Legislature, for a committee on social services.The gap could only get worse. Utah’s Medicaid rolls are expected to swell in 2014, when the federal health care act could motivate more people to apply for Medicaid coverage.

Doctors said Medicaid often feels like an annoyance that isn’t worth their time.

“In the current system, the biggest hassles and the lowest reimbursements are paired together,” said Brian Hales, a Davis Hospital anesthesiologist and president of the Utah Medical Association. “I pay my car mechanic much more per hour than (doctors get) to sit for an hour with a very sick patient.”

Without the benefit of patients with private insurance, many doctors can’t survive financially, doctors said.

“If you’re a private provider in Milford, you’re losing money,” said King Udall, a family physician who works for Intermountain Healthcare, Utah’s largest medical provider.

Their professional code compels them to provide care no matter the reimbursement, but “some of that idealism runs low after a while,” Udall said. “You’d like to break even.”

Advocates for the poor said they understand doctors’ complaints. But many variables determine what doctors get paid, including what type of medicine they practice, they said. Specialists earn more than family doctors. And independent doctors get paid differently than managed care providers.

The primary concern is that people get medical care, said Lincoln Nehring of Voices for Utah Children.

Utah lawmakers are concerned about the shrinking pool of doctors in the Medicaid program, said Rep. Ronda Rudd Menlove, R-Garland.

Lawmakers funded additional slots at the University of Utah’s medical school and are talking about ways Utah might change its health care delivery models, she said. It could include expanding the use of community-based clinics and relying on nurses to provide more care.

“We really have to be innovative. We can’t just say we’re going to do things the way we’ve always done it,” Menlove said. “We’re also going to have to look at the payment structure. I don’t know how we deal with that, but I think we can’t ignore what (doctors) are talking about, which is low pay.”

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