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Medicaid Reforms that Make Sense

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Our Country and our Commonwealth face a significant challenge when it comes to providing health care treatment to an aging population.  It is estimated that 10,000 people a day will walk, run or crawl into retirement for many years to come.  Regardless of how any of us feel about various proposals to address the health care needs of this growing population, the strain on our society will be immense.

Many are positioned to care for their own needs.  Many are not.  For those who rely on government service – Medicaid – it is critical to pursue policies that allow for the most cost-effective treatment to provide care that is most beneficial to the recipients.  That would certainly include providers of in-home care, the least expensive government option for providing such care.

As noted in a September article, the Virginia Association of Personal Care Providers represents agency-directed care by more than 70 member firms across the state.  While personal care providers comprise a relatively small percentage of the total Medicaid expenditures in Virginia, our services save millions of dollars which would otherwise be spent housing and treating the aged and infirmed in nursing homes, hospitals and assisted living facilities.

That said, changes are needed in Virginia’s Medicaid program to ensure an adequate number of quality providers are available to serve the aging population in the future.  As Virginia government makes critical decisions about Medicaid expenditures, we offer these specific items for consideration.

First, Medicaid reimbursement rates should be increased.  Despite two decades of analysis and recommendation, the Medicaid reimbursement rate for personal care providers in Virginia ranks third lowest among all states.   Not only does this rate depress the ability of agencies to employ quality employees, it does nothing for those employees who care for our aging parents and grandparents.  This is not work for the faint of heart. A system that depresses wages but expects more does not represent a good prognosis for a healthy and quality provider network.

Second, there needs to be an on-going work group consisting of providers and Department of Medical Assistance Services (DMAS) leadership to ensure the appropriate use of public money expenditure, as well as to ensure the reduction of onerous regulations which do little to enhance quality of service provided but instead have a costly impact on providers – most of whom are small businesses.

Third, with the expanding coordinated care program, the General Assembly should mandate that performance contracts with managed care organizations do not provide financial incentives which penalize providers or negatively impact patients.
I am proud of the service that agency-directed firms provide.  But, on a daily basis, I am acutely aware of the increasing demands to serve more with less.  Left unattended, it is not a sustainable trend.
All our industry is seeking is a level playing field for performance and oversight.  We will work aggressively with Virginia government toward that goal.

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