Virginia Regulatory Town Hall
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Department of Medical Assistance Services
 
Board
Board of Medical Assistance Services
 
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6/19/20  10:48 am
Commenter: Pranav Virmani, MD. CEP

Detrimental impact on Minorities.
 

How this impacts health equity:

While Medicaid patients will continue to receive care and will never be billed for the difference if the visit is determined to be non-emergent, patients will be impacted because: 

 

  • Such dramatically reduced payments will result in fewer physicians in the ER and much longer wait times, specifically in urban and rural hospitals, which have a higher percentage of Medicaid patients.

 

  • The financial viability of these emergency departments and medical centers is already threatened due to losses from COVID-19 where, during lockdowns, volumes declined as much as 40% due to both a lack of vehicle traffic and patients delaying care and avoiding emergency rooms.

 

  • Underrepresented minorities have always lacked access to healthcare and suffered the worst outcomes in the U.S. Emergency physicians are the healthcare safety net when Medicaid recipients do not have adequate access to primary care and public health. These minority groups would be disproportionately impacted and suffer disproportionately when critical-access hospitals lose Medicaid funding essential to their survival. 

 

  • Minorities in the U.S. disproportionately have higher rates of co-morbidities that increase risk factors for COVID-19 (obesity, lung disease, diabetes, hypertension, and other immune-compromising diseases). Many of those conditions are on the “preventable” diagnosis list.

 

  • Emergency physicians are dedicated to our national mission to promote and strive toward health equity within the communities we serve. Allowing such an unfair policy to go into effect in Virginia would be a significant step backward towards racial equality and social equity.

 

How this issue impacts hospitals and health systems: Medicaid reimbursements would be automatically cut to only $14.98 if an ER visit is on the list of “preventable” codes.  Such a low reimbursement makes full staffing of a hospital emergency department very precarious, especially in urban and rural areas who typically have high Medicaid populations. 

CommentID: 80726