Letters: Need higher Medicaid rates – NJ.com

Edison residents Bharatiben Dhebaria, left, and her husband Dhiru Dhebaria at their home in Edison. Dhiru was able to enroll in expanded Medicaid for himself, but his wife didn’t receive anything in five months, on Wednesday April 2, 2014.
Patti Sapone/The Star-Ledger

In an April 23 NJSpotlight Profile, Uwe Reinhardt, Professor of Economics and Public Affairs at Princeton University, discussed some of the problems caused by low Medicaid reimbursement rates, notably that a majority of physicians refuse to accept Medicaid recipients as patients. This is not the only way in which low rates limit access to health care for Medicaid recipients.

Medicaid is also what supports a significant portion of community-based mental health services, and New Jersey has the second-lowest rates in the country. Not only do the rates paid to community-based providers not cover the full cost of providing treatment, but, in many cases, Medicaid disallows billing for important components of care such as transportation to and from clinics.

As Professor Reinhardt noted, “The problem is particularly disturbing because lower-income residents are more likely to have multiple chronic conditions than wealthier patients.” Inadequate rates are limiting access to care for those who need it most.

The State of New Jersey is moving toward a new Medicaid payment system. The New Jersey’s Division of Medical Assistance and Health Services (DMAHS) and Division of Mental Health and Addiction Services (DMHAS) are currently developing new rates for community behavioral healthcare providers. Distinct from this process, the New Jersey Department of Children and Families (DCF) is developing new rates for children’s services.

In all cases, the state should be mindful of the harm that can be done when providers are insufficiently reimbursed for services — those services disappear as the businesses cannot sustain themselves. New Jersey’s children and adults that rely on the community behavioral health system deserve quality care that is readily accessible, and that can only be achieved by adequately funding community-based providers.

DEBRA L. WENTZ

NEW JERSEY ASSOCIATION OF MENTAL HEALTH AND ADDICTION AGENCIES

MERCERVILLE