As Medicaid shrinks, clinics for the poor try to survive

As Medicaid shrinks, clinics for the poor try to survive

These health centers each experienced revenue losses of at least $500,000 due to the Medicaid cut, according to Amy Simmons Farber, a spokeswoman for the health center association.

As of late December, Family Health Centers, a network of clinics in Louisville, Ky., had lost more than 2,000 Medicaid patients since the policy change took effect in April, a drop of nearly 6 percent , said Melissa Mather, spokesperson for the clinic. For every percentage drop in Medicaid patient visits, she said, the clinic experiences a $175,000 to $200,000 drop in revenue.

Bethesda is now engaged in a “monthly survival game,” said Amber Greene, Bethesda’s operations manager, who also works as a nurse. Standing in a supply closet to make her point, she gestured to a modest supply of Tylenol, Motrin and thermometers, which the nearby church had donated.

The clinic, where the vast majority of its patients are on Medicaid, needs about $115,000 a month to operate its medical and dental clinics, but still runs a monthly deficit of about $10,000. Sometimes the costs are minimal, such as the fee for the vaccine that Dr. Price gave to the mother who could not pay. But they add up, forcing the clinic to get creative to preserve funds. A local pharmacy offers antibiotics at deeply discounted prices, and the clinic has reduced the costs of its virology testing by performing it in-house.

Texas health officials defended the unwinding as a natural return to the shape and size intended by Medicaid. Conservative health policy experts also supported it is important to reduce staff numbers to financially maintain the program.

“The reality is that many healthcare professionals cannot sustainably see Medicaid patients because the program reimburses so little and the claims process is so excruciating that many providers end up suffering losses to the point of threatening to close,” said Tanner Aliff, a health policy expert. at the conservative Texas Public Policy Foundation.

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Eric D. Eilerman

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