Primary Care, Medicaid News

The shortage of primary care physicians and primary care in general has been widely reported. According to the Texas Tribune, for example, the federal government has declared Harris County a primary care physician shortage zone. The health care reform law will result in millions more Texans on the Medicaid rolls. Who will treat them?

CMS announced a program to alleviate some of the pressure. The initiative will provide funds to hospitals to increase training for advanced practice registered nurses, which includes nurse anesthetists and midwives. An excerpt:

The demonstration requires that half of clinical training occur in non-hospital settings in the community. Most clinical training in large hospitals already includes some rotations in settings that treat minority and underserved populations; however, this demonstration sets a higher requirement for training in non-hospital community-based settings. Students receiving training funded by the demonstration will be encouraged to practice in non-hospital community-based settings, including in underserved areas….CMS will select up to five eligible hospitals to participate in the demonstration.  The demonstration is expected to run for four years.

In related Medicaid news, Bloomberg reports that CMS is revising the requirement that nursing facilities hire independent pharmacists to oversee resident drug regimens. Why? Because the change “would be highly disruptive to the industry” without corresponding benefit.

States are holding their collective breath as they await the U.S. Supreme Court’s decision on whether the heath care reform law is constitutional. According to various sources, the justices seem inclined to strike down at least the individual mandate, which requires the uninsured to become insured or face a fine. Meanwhile, public and private hospitals in Texas are in a conflict over Medicaid. From the Houston Chronicle:

Texas’ public hospitals are asking the state to make some taxpayer money now spent on Medicaid care instead pay for the uninsured, a group that soon may be mostly illegal immigrants.

The proposal, under consideration by the Texas Health and Human Services Commission, is pitting public and private hospitals against each other for hundreds of millions of dollars allocated annually in a supplementary Medicaid program. The public hospitals argue the program favors private hospitals.

The program makes up some of the difference between what hospitals spend caring for Medicaid patients and the uninsured poor and what the federal government reimburses them. As chairman of the public hospital group, Lopez in February wrote HHSC Executive Commissioner Tom Suehs proposing that the program instead pay solely for the uninsured, public hospitals’ largest patient group.