leslie herrod
mary young
Affordability and accessibility of health insurance is a top concern for Colorado patients, families, and legislators, and has been for decades. More specifically, the importance of health equity, the idea that everyone is entitled to the same quality of health care, has emerged in recent years.
However, Colorado has taken steps to create inequities in health care access and treatment within the state by significantly lowering Medicaid reimbursement rates for anesthesia care. The rate recommended in this year’s governor’s budget proposal would reduce reimbursement rates for this critical care care by a whopping 37.5%.
The Medicaid Provider Rate Review Advisory Committee (MPRRAC) annually presents to the state Joint Budget Committee (JBC) a summary of reimbursement rates and proposed strategies to address the review findings. The 2023 Anesthesia Rate Review was conducted after consultation with just one provider, resulting in recommendations that will benchmark Medicaid reimbursement rates for anesthesia care against Medicare, resulting in a nearly 40% reduction. Ta.
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This significant reduction will impact both anesthetists and nurse anesthetists alike, but the impact will be felt the most by Colorado patients. This large-scale rate reduction applies to people most likely to need anesthesia care under the Medicaid program, including low-income Coloradans, pregnant women, children, people of color, people with disabilities, seniors, and people living in rural areas. It could exacerbate the already significant inequities in health care that people face. region of the state.
The Medicaid program covers one in four Coloradans, and 66% of these patients are people of color. Although the majority of Medicaid patients live in urban centers, more than 20 rural counties have more than 35% of their population dependent on Medicaid. Her three rural counties rely on the Medicaid program for more than 50% of their population. Reducing Medicaid reimbursement rates for critical anesthesia care would disproportionately jeopardize the health and medical outcomes of Medicaid patients and further widen already significant health disparities.
These cuts could lead to lower standards of care and worse health outcomes for patients receiving Medicaid, but they would not meaningfully reduce health care costs.
This policy was developed by bureaucrats, not health care providers or caregivers, and is based on flawed data that is inconsistent with other health care organizations and health care reimbursement rates. Colorado has no other payment system that benchmarks anesthesia fees to Medicare. Commercial insurance companies don’t, Colorado Workers’ Compensation Insurance doesn’t, and prior to this recent proposal, Colorado Medicaid didn’t either.
Medicare reimbursement rates for anesthesia care are due to a fundamental flaw in the system’s original design, which does not take into account the actual cost of anesthesia services. To date, this error has not been fixed. According to a 2020 report, Medicare pays significantly less for anesthesia services compared to other physician services compared to the commercial market. In fact, Medicare pays rates that are about one-third of commercial market rates, but Medicare pays rates that are about 75 percent of commercial rates for services performed by other physicians. Anesthesiology practices have limited ability to offset reductions in payment rates, and reductions in payment rates impact anesthetists, anesthesiologists, and anesthesiologist assistants across the board.
Our health care system is entrenched with countless policies and practices that disenfranchise and exclude certain people, resulting in poor care based on income, race, region of the state, and other factors. The stages are different. This tiered system also makes a huge difference in medical outcomes. The importance of proper anesthesia care for patients cannot be overstated. Access to appropriate anesthesia care is important in reducing surgical complications, patient pain levels, recovery time and overall costs, increasing mobility, and improving overall positive patient outcomes. play a role.
Additionally, the Colorado Office of Health Policy and Financing in a recent report found that two key areas are increasing access to care at low-cost ambulatory surgery centers and efforts to improve pregnancy outcomes and reduce the number of pregnant women born. It made clear that there is an opportunity to address health disparities. Morbidity and mortality. However, the critical role that access to optimal anesthesia care plays in achieving success in both fields is not accounted for.
We should all strive to ensure that everyone in Colorado receives the same quality of care that they want for themselves and their loved ones. We understand that state budgets are tight, but the budget should not be balanced at the expense of Medicaid patients, who already face serious barriers to health care.
State Representative Leslie Herrod represents Denver’s 8th Congressional District and serves on the Appropriations and Judiciary Committees. State Rep. Mary Young represents Weld County House District 50 and serves as vice chair of the Health and Human Services Committee and the Education Committee.
