When Tom Suehs, executive commissioner of Texas Health and Human Services, addressed the Senate Finance Committee in a hearing on Feb. 1, he told the 15 senators in no uncertain language that going through with cuts to primary care proposed in the Senate’s draft budget will damage access to care.
Suehs (pronounced “seas”) is pushing for exceptional items that would reduce the cut in payment for primary care physicians treating kids enrolled in Medicaid and CHIP from 10 percent to 2 percent. This would cost the state around $125 million in general revenue next biennium, according to a Feb. 1 article in Quorum Report.
“I’m really concerned about having to cut primary care rates for physicians treating children,” Suehs told the committee. “We’ve already cut 2 percent this biennium from when y’all wrote the [2010-2011] budget. I believe that’s about as far as I can tolerate to maintain the access to primary care so I’m asking to put back not all 10 percent, but 8 percent. Exceptional item 1A is for Medicaid children, exceptional item 1B is for CHIP.”
Suehs emphasized his desire to make “targeted cuts to minimize hits to access to care” rather than an across-the-board cut for providers—as has happened in the past.
More than the provider pay cuts in Medicaid and CHIP, primary care took a beating in the draft budgets released by the House and Senate (read the “Bleak House” post). The House version eliminates funding for the Texas Family Practice and Primary Care Residency programs, the Physician Education Loan Repayment Program, and the Primary Care Preceptorship Programs. The Senate version cuts the residency programs by 29 and 45 percent, respectively, with other cuts to graduate medical education.
TAFP CEO/EVP Tom Banning says in a Feb. 2 article in the Texas Tribune that this isn’t the time to make cuts to primary care. Instead, lawmakers should explore ways to reduce health care costs to the state by investing in programs that reward doctors to achieve the best medical outcomes. It sounds contradictory to spend more to save, but outcomes-based initiatives that support primary care are gaining ground; pay-for-performance programs and medical home initiatives, for instance.
Banning supports Suehs’ commitment to preserving primary care and sees it as a positive indicator that primary care will survive a tough session. He wrote in an e-mail to Academy leaders, “I think this clearly points to the value and importance that HHSC and the legislative leadership is placing on primary care. This should play well into our strategy to restore higher education funding to produce the primary care workforce Texas needs to achieve their policy objectives.”
Before ending on too positive of a note, John Reynolds in the Quorum Report article foretells a battle if primary care receives special treatment and other providers receive the full cut. “What to one person is protecting a vital part of the health care system from being dismantled might sound to another like creating a set of winners and losers. And that’s a formula for conflict.”
Here’s the link to the Quorum Report article (full text for subscribers only): http://www.quorumreport.com/Subscribers/Article.cfm?IID=16647
Here’s the link to the Texas Tribune article: http://www.texastribune.org/texas-health-resources/health-reform-and-texas/are-payment-reform-texas-budget-in-conflict/.