More Patients, Less Money for Doctors

摘要

Sandhills Pediatrics, a group practice near Fayetteville, N.C., recently hired a child psychiatrist and a psychiatric nurse practitioner. It also expanded a satellite office in Hoke County, where almost a third of children live in poverty. About half of Sandhills' 20,000 patients are covered by Medicaid, the joint federal-state health program for the poor, and the practice was able to add the services thanks to a boost in the reimbursement rates Medicaid pays primary-care doctors under the Affordable Care Act. The 2010 law guaranteed federal funding to cover the higher rates only in 2013 and 2014. President Obama's proposed 2015 budget would have continued the higher payments, but that provision never made it into the $1.1 trillion spending bill Congress passed on Dec. 13. As a result, federal reimbursements will drop to 2012 levels starting in January. Sandhills expects its Medicaid revenue to fall 26 percent next year. "It means a tremendous loss," says Sandhills managing partner Christoph Diasio.