Why is it SO hard to find good care when Medicaid is your insurance carrier?
Well, here’s the succinct answer provided by a recent communication from our billing service [plus extra comments and explanations from Kristin]:
“I am writing today with extremely disappointing news. Washington State Healthcare Authority (HCA, DSHS, Medicaid, ProviderOne, Apple Health) has dropped the reimbursement rates effective July 1, 2016 for birthing centers and global maternity care below the rates that were in effect 3 years ago.”
This means that Medicaid is reducing their payments for care that has already been provided and completed.
“Global maternity care is now being reimbursed at $1,992.84.”
Compare that to the global fee of $3000-4500 charged by the average Licensed Midwife and the $3500 charged by Sunrise Midwifery. Keep in mind that each client on Medicaid also costs the midwife the billing fee of about $200-400, reducing the overall income even more.
“The facility fee reimbursement rate is $584.61.”
This means a birth center is paid ONLY $585 per birth. The per birth cost to the birth center for just having a birth occur in the facility is over $750! In essence, the birth center or provider must PAY to have a Medicaid birth take place at their facility. It is unsustainable.
“This is a 3.5% decrease in reimbursement.”
What? After the past years of MAWS working so hard to get better reimbursement for midwives, and proving our value to the system, they reduce our pay? You mean they want us to do more care, work harder, fill out more paperwork, while they pay us less?
“Midwives are not being specifically targeted. These rates are the same in the Physician-Related Services fee schedule. You can download the current and previous fee schedules for Planned Home Births and Births in Birthing Centers or Physician Related Services at: http://www.hca.wa.gov/billers-providers/claims-and-billing/professional-rates-and-billing-guides“
That link shows you how much Medicaid pays for each service.
You need to get involved in the legislative process to make a change and get better access to care!
- The Midwives Association of Washington State is the first place to start for resources and information regarding lobby days and reimbursement committee participation.
- JOIN MAWS TODAY as a supporter to help us keep the midwives and birth centers in business.
- Call Kristin anytime to find out more.