Medicaid, Radiology and Caring for Patients

Raymond Tu, MD, MS, FACR, neuroradiologist, chair of the Medicaid Network and president of the Medical Society of the District of Columbia, Progressive Radiology, Clinical Associate Professor George Washington University Hospital and Chair of Radiology United Medical Center/Not-For-Profit Hospital Corporation and BridgePoint Hospitals at National Harbor and Capitol Hill, Washington, DC.

Medicaid serves as a lifeline for low income Americans across the country. It has also been a consistent target of political debate the last several years.

Since its introduction in 1965, Medicaid has grown and evolved from a program meant to serve low-income women and children to a state-federal partnership that each state develops to best serve its population.

image3To further complicate the Medicaid program, many states elect to place beneficiaries in managed care organizations (MCOs). The Affordable Care Act (ACA) dramatically changed the Medicaid program, and various Administrative and Congressional proposals have been introduced to further alter the foundation of Medicaid. Medicaid programs across the country have struggled to recruit providers since Medicaid tends to have lower physician reimbursement rates.

What does that mean for us, as physicians? Despite these challenges and many misconceptions, the Medicaid program has improved access and reduced delays in care for low-income beneficiaries. This calls for increased attention from members to protect Medicaid beneficiaries from losing access to necessary medical care. The ACR has a loyal and passionate group of members and staff who continuously monitor the Medicaid program to safeguard both providers and patients.

During ACR 2019, the Medicaid Network had the opportunity to meet and discuss diverse Medicaid problems facing members across the country. Our engaged Network members shared their experiences from their respective states, and how they are working with state and federal partners to ensure all patients can access imaging services.

medicaid1The discussion began with Neil Davey, MD, FACR sharing his experience of working in Idaho, where voters passed Proposition 2 to expand Medicaid beginning January 1, 2020. Idaho will be pursuing work and community engagement requirements seen in other Medicaid programs and which have created controversy among Medicaid experts.

Robert Achermann, JD, discussed the ongoing changes in California, where 16 million people are covered by the MediCal program. A discussion led by Michael Otte, MD, Board, CRS and Taj Kattapuram, MD, Legislative Chair, CRS, explored the intricacies of provider payments for Medicaid in Colorado. The members explained that Colorado Health First (Colorado’s Medicaid program) aims to have provider payments for all specialties as close to 100% of Medicare payment rates. These engaged members met with Colorado Health First to advocate for appropriate provider payments rates for radiology.

Colin Segovis, MD, PhD, Kathleen Gundry, MD, FACR and Frederick Murphy, MD, FACR discussed Patient First Act in Georgia. Georgia continues to expand Medicaid, but may look for a model to expand up to 100% FPL. It was also discussed that the city of Atlanta has implemented a program to use social workers to address emergency department “frequent fliers.”

With support from ACR staff, the Medicaid Network posts weekly on Engage to keep ACR members updated on Medicaid news and developments. The Medicaid Network continues to seek engaged members to join us.

  • Have questions about the important work of the Medicaid Network? The ACR staff is an excellent resource. Please feel free to reach out to Christina Berry, cberry@acr.org, for more information about how to get involved.
  • What challenges have you faced in caring for Medicaid patients?

Please share your thoughts in the comments section below and join the discussion on Engage (login required).

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