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Medicaid Reform: The Medical Side. Ed Weisbart MD April 3, 2013. “The Missouri State Medical Association encourages the Missouri state legislature to expand Medicaid in the manner enabled by the Affordable Care Act.” January 2013. MSMA Is Not Alone In Supporting Medicaid Expansion.

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medicaid reform the medical side

Medicaid Reform:The Medical Side

Ed Weisbart MD

April 3, 2013

slide2

“The Missouri State Medical Association

encourages the Missouri state legislature to

expand Medicaid

in the manner enabled by

the Affordable Care Act.”

January 2013

msma is not alone in supporting medicaid expansion
MSMA Is Not Alone In Supporting Medicaid Expansion

Ambulance District Association of Missouri

American Cancer Society

American Diabetes Association

American Heart Association

American Lung Association

Missouri Academy of Family Physicians

Missouri Academy of Pediatric Dentistry

Missouri Alliance for Home Care

Missouri Ambulance Association

Missouri Association of County Developmental Disability Services

Missouri Association of Free Clinics

Missouri Association of Health Plans

Missouri Association of Nurse Anesthetists

Missouri Association of Rural Health Clinics

Missouri Centers for Independent Living

Missouri Chapter March of Dimes

Missouri Chapter of the American Academy of Pediatrics

Missouri Chapter of the American College of Physicians

Missouri Coalition of Community Mental Health Centers

Missouri Dental Association

Missouri Dental Hygienists’ Association

Missouri Developmental Disabilities Council

Missouri Emergency Medical Services Association

Missouri Health Care Association

Missouri Hospital Association

Missouri Nurses Association

Missouri Optometric Association

Missouri Pharmacy Association

Missouri Primary Care Association

Missouri Psychiatric Association

Missouri Public Transit Association

Missouri Section of the American Congress of Obstetricians and Gynecologists

Missouri State Medical Association

MS Society

The Congress on Disability Policy

The Leukemia and Lymphoma Society-Gateway Chapter

recap of msma discussions
Recap of MSMA Discussions

“Let’s be on the right side of history”

medicaid is good for patients

A randomized controlled trial

Medicaid Is Good for Patients

Oregon Health Insurance Experiment

NBER Working Paper #17190, 2011

http://www.nber.org/papers/w17190.pdf?new_window=1

medicaid is good for patients1

A randomized controlled trial

Medicaid Is Good for Patients

Oregon Health Insurance Experiment

NBER Working Paper #17190, 2011

http://www.nber.org/papers/w17190.pdf?new_window=1

medicaid is good for patients2
Medicaid Is Good for Patients

Not quite as good

as private insurance;

much better

than no insurance

“Medicaid” includes other public insurance

KCMU analysis of 2010 NHIS data, per ACP

Uninsurance mortality from Wilper et al. Am J Public Health 2009.

medicine is hard enough practice is really tough
Medicine Is Hard EnoughPractice Is Really Tough

More than

$200,000

Accounts Receivable

for a typical

single physician practice

Nearly

12 Months

Average physician

Accounts Receivable

aging balance:

Personal communication with Missouri State Medical Association. April 12, 2013

it s just arithmetic
It’s Just Arithmetic

Low wage job

+ Medical bills

+ No health insurance

Medical Group

Accounts Receivable

who is uninsured in missouri
Who Is Uninsured in Missouri?

Exchange

Eligible

Jan. 1, 2014

Medicaid

Expansion

Eligible?

Uninsured Missourians

Income as a percentage of FPL

http://www.statehealthfacts.org/comparecat.jsp?cat=3&rgn=1&rgn=27

Accessed April 10, 2013

slide11

Primary care services in Missouri paid at

59% of Medicare

http://www.kff.org/medicaid/upload/8398.pdf

slide12

“Expand Medicaid?

Why would I want more Medicaid patients?”

slide13

Overall 76% increase

for primary care services in Missouri

http://www.kff.org/medicaid/upload/8398.pdf

so where are my increased rates
So Where Are My Increased Rates?

“…optimistic that something will move forward soon.”

Ian McCaslanMD

Director of MO HealthNet

be of good cheer
Be of Good Cheer
  • “Missouri will expand Medicaid.
  • I’m just not sure which year.
  • Don’t give up.”
  • – Rob Fruend, CEO
  • STL Regional Health Commission