Medicaid is one of Hawaii’s largest government programs, with and annual budget of $2 billion and 345,000 members, but doctors have long complained that Quest doesn’t fully reimburse them for the cost of caring for low-income patients, the aged, blind or disabled.
Kaiser said, “What are we to do if a government payer doesn’t pay enough? After all, people can only take on so many of those patients. And if gets to be too many of them, oh well!”
Hey, if a doctor can do it why can’t a provider? After all, see it as a benefit. If they are low-income, aged, blind or disabled and they cannot pay for their health care, it will speed up their demise.
Despite Kaiser saying it’s a part of their mission to improve the health of the communities they serve, and that includes taking care of those who are the most vulnerable, they also say they cannot take care of everyone if it affects their profit.
To stay in business, providers must strike a balance with higher-paying privately insured patients to offset the lower Medicaid reimbursements. That means that new Quest enrollees have difficulty finding primary care providers. Oh well!
Basically, if a low-income person can’t find a doctor who will accept a lower fee, what can you do? After all, the doctor has to make sure he can sustain his luxury home, Mercedes and golf club membership and must detach himself from someone that cannot contribute to that sustainability.
Kaiser said it has more than 700 physicians and providers in more than 60 specialties to serve (no laughing allowed) its more than 240,000 “tricks”. They also said that all their “tricks” are treated equally (as long as they can pay) and receive the same high-quality care, even those members with the low Quest payments. But new ones? Hell no!
Somehow Kaiser, rated the top Medicaid plan in the country based on quality and patient-satisfaction by the National Committee for Quality Assurance (I wonder how many Kaiser executives are in this group?), has closed enrollment before for the same reason – No money? Don’t let the door hit you in the butt on the way out!
Kaiser has a limit of 25,000 Medicaid enrollees, bit it increased capacity during open enrollment under Obamacare and allowed people to choose them. Since that did help much monetarily they closed the new enrollment.
Then HMSA came to the rescue by saying that more than 800 primary care doctors in its network care for Quest patients and that almost 500 of these physicians are accepting new enrollments. They said it was important to them to care for all Hawaii residents, regardless of their financial situation.
Hawaii needs an additional 450 primary care physicians to meet its residents’ needs. In a perfect world all doctors would take all patients and not have to worry about income or insurance types. But, it’s not a perfect world so let the chips fall where they lay.
Medicaid and MedQuest patients are often the patients with the greatest health care needs, and reimbursement for them is lower than most insurances, making it very difficult for those with Medicaid and MedQuest to find providers. That being the reality, so is one’s lifestyle.
So, even though Kaiser and HMSA’s hearts go out to those that are impoverished, in God we trust, all others pay cash!