“rob Peter to pay Paul.” This familiar phrase means to take something from one person or thing to pay a debt to another.
This old saying describes what happened to health care when lawmakers reached a decision to avert the fiscal cliff.
Physicians were set to see their Medicare reimbursement reduced by 26.5% on January 1. Congress wisely spared physicians the cuts but the deal is expected to cost each Missouri Hospital millions of dollars in federal payments intended to treat the needy.
About half the money to circumvent the 26.5% Medicare payment cuts to doctors will be made up by reducing hospital disproportionate share payments. The disproportionate share payments are given to hospitals that tend to treat a higher percentage of poor patients suffering from chronic conditions. The situation will be worsened in Missouri if the state chooses not to participate in the Medicaid expansion because the expansion would help to recover some of the cost of treating needy patients.
Reducing hospital payments to support physician payments isn’t a long-term solution especially at the expense of some of our most needy citizens. If Missouri fails to expand Medicaid the health of Missouri will be affected and hospitals will be forced to deal with billions of dollars of cuts from the Affordable Care Act and a mandate to provide a safety net without resources.