AUGUSTA – Maine hospitals worry that some of the budget cuts proposed by Gov. John Baldacci could result in program cuts and layoffs.

Facing a $140 million revenue shortfall over the next six months, Maine’s Democratic governor recommended reducing the reimbursement rate paid to hospital physicians for treating MaineCare patients. The move would equalize the MaineCare reimbursement rate between privately practicing physicians and hospital-based doctors, producing a six-month savings of $3.5 million, according to the budget proposal.

Mary Mayhew, vice president of the Maine Hospital Association, said the cuts would really be more.

“For every dollar you cut at the state level, you lose two from federal Medicaid, so it’s a $20 million annual cut to hospital-based physicians,” she said.

David Farmer, spokesman for Baldacci, said private physicians are able to manage now under those rates.

But Mayhew said many private doctors decline to treat MaineCare patients because the rate is so low.

“It has driven most privately practicing physicians to hospitals,” she said. “Or if they’ve stayed in private practice, many of them have closed their doors to MaineCare patients.”

Chuck Gill, spokesman for Central Maine Medical Center in Lewiston, said the hospital already is losing money by treating MaineCare patients and this move will further drive up costs for people paying for private insurance.

“The reason health care costs are higher to Anthem and everybody else is we don’t get paid by MaineCare so we shift the costs to others,” he said. “That’s widely known.”

The more the state declines to spend on MaineCare payments to hospitals, the more somebody who is paying private insurance has to pay, Gill said.

“It may not be today, but down the road,” he said. “It’s shifting the burden of the cost of health care away from the state and back to people that are paying for their insurance.”

Farmer said the tough economic times have made for tough choices.

“We understand this will pinch the bottom line on hospitals, but we don’t believe that it necessarily means there will be a reduction in service to patients,” he said. “We did it because we thought there was an equity issue between the private practice doctors and the hospital-based doctors and frankly, this was a budget-based decision.”

Gill said the state already owes CMMC about $55 million in MaineCare payments going back to 2005 and he is worried that with less funding the hospital will not be able to recruit and retain doctors.

“Maine’s attractive, but if you can make 50 percent more or 100 percent more somewhere else, you can always visit,” he said. “If we can’t provide competitive salaries, you’ll see longer waits to get into the doctor, you’ll see people going to the emergency room instead of the primary care offices or leaving the state for health care.”

Farmer acknowledged the state’s debt to hospitals but said he does’nt think they are as low on funds as they say they are.

“We recognize that obligation and are committed to meeting it,” he said. “But when I look around, I see hospitals seem to be able and willing to make major capital expansions and they don’t appear to be cash-strapped. There are major capital improvements going on, major construction, major expansion going on at the hospitals.”

Both sides say it is now up to the Legislature to decide whether to keep the governor’s proposal or make cuts elsewhere. Public hearings on the budget began this week and will continue throughout the next few weeks.

Copy the Story Link