Health Care Providers Call For Continuation Of Medicaid Reimbursement Boosts

Affordable Care Act Provision That Increased Reimbursements For Primary Care Doctors Ends This Week

A Wisconsin Hospitals Association spokesman says hospitals shifted $960 million in unpaid BadgerCare costs last year. Photo: Omar Barcena (CC-BY-NC).

A boost in Medicaid reimbursement for primary care doctors that was enacted as part of the Affordable Care Act is set to end this week, but some health care providers are calling for the funding to continue.

If the federal government doesn’t extend funding, the Wisconsin Hospitals Association’s Eric Borgerding said the group will push the state to pay more in the next budget. Borgerding said Wisconsin’s BadgerCare program pays 65 cents of every dollar a hospital spends on patient care.

“That 35 cents of cost that’s unpaid by Medicaid has to be shifted to everyone else,” said Borgerding.

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Borgerding said hospitals shifted $960 million in unpaid BadgerCare costs this year.

For some providers, Medicaid reimbursement boosts are nothing new. The Wisconsin Primary Health Care Association is made up of 17 federally qualified community health centers. The centers serve high-need groups in rural areas or inner cities that see more poverty. CEO Stephanie Harrison said the centers have been receiving higher Medicaid reimbursement for years.

“That reimbursement rate has been really critical to our ongoing viability because it’s really difficult to attract and retain providers in these underserved areas of our state,” said Harrison.

The WHA’s Borgerding said higher payments will encourage more doctors to provide care to Medicaid patients, and more access to care will keep people out of emergency rooms.

“A very expensive place to have primary care is in the ER,” said Borgerding.

Gov. Scott Walker has rejected $4.4 billion in federal funds to expand Medicaid. He’s said it’s uncertain whether the federal government would come through with the money.

Around 1.2 million people take part in Wisconsin’s Medicaid program.