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Local Medicaid providers face possible cuts after state budget shortfall, county health contractor warns
Summary
Partners Health Management warned Burke County commissioners that the state DHHS mini-budget left a $319 million shortfall and that proposed provider rate cuts of about 3%, 8% or 10% (depending on service) could begin Oct. 1 unless the legislature addresses the gap; Holden named the four standard managed-care plans serving the county.
Paul Holden, regional director for Partners Health Management, told Burke County commissioners on Oct. 6 that the state's shortfall in DHHS funding could reduce Medicaid provider reimbursement and threaten service availability.
Holden explained that Medicaid services in Burke County are delivered through multiple managed-care options and said, "In Burke County, there are 4 standard plans" — AmeriHealth Caritas, WellCare, UnitedHealthcare and HealthyBlue — and that Partners also serves members in Tailored Plans for higher-need populations. He cautioned that the state Department of Health and Human Services' mini-budget came up roughly $319,000,000 short of its request to the legislature, and that absent new funding the department proposed provider-rate reductions starting Oct. 1 of approximately 3%, 8% or 10% depending on the service type.
Holden said those cuts could prompt some small agencies and providers to reconsider whether to continue accepting Medicaid, because reimbursement reductions on top of rates that in many cases have not been updated in years may become unsustainable for smaller providers.
He told commissioners the legislature returns Oct. 20 and that the board should expect an update then about whether the shortfall is addressed. Holden offered to return with follow-up information after the legislature meets.
