From the Desk of North Oaks Health System President/CEO Michele Sutton, Dear Editor:
As a health care professional for the past three decades, I would like to address recent criticism of the expansion of Medicaid.
For nearly 40 years, Medicaid has functioned as the nation’s health care safety net by providing access to health services to those who cannot afford private insurance. Today, more than 72 million low-income Americans rely on this vital program to provide access to health care. With implementation of the Affordable Care Act (ACA), more than 15 million Americans, 350,000 of whom are Louisianans, are newly enrolled in Medicaid (based on May 2016 CMS estimates).
Medicaid’s mission is more critical now than ever before in helping our state’s children, poor and disabled. Many Louisianans are suffering financially and physically. Our poverty rate is the third highest in the country. We rank first in adult obesity and incidence of STDs, third highest in cancer mortality and fourth highest in adult hypertension. The expansion of the Medicaid program is an opportunity to give our most vulnerable citizens acute and preventive care and positively impact long term health outcomes.
This essential program, like any insurance program, admittedly has its flaws. But data proves that even after only six months, coverage is translating into access across our community and the state. From primary care visits and cancer care to diabetes management and so much more, hundreds of thousands of Louisianans are now getting needed health services.
In the 12 months prior to Medicaid expansion, more than 12,500 patients came to the North Oaks Medical Center Emergency Department with no type of medical insurance coverage. Some had suffered profound traumatic injuries, like our patient with a broken neck that left him paralyzed from the shoulders down. Because we were able to enroll him in Medicaid while still hospitalized, we were able to transfer him to a Neurological Rehabilitation facility. Without it, this patient would not have had access to treatment that allowed him to gain function in his upper extremities.
Access to preventive care also has improved. In the seven months since the expansion, North Oaks has seen a 60% increase in Mammograms and a 61% increase in Bone Density screenings for Medicaid patients, a 26% increase in Cervical Cancer Screenings, a 20% increase in A1C screenings for diabetes and an 18% increase in cholesterol screenings. These are all real people, with real needs, who have had their lives changed for the better.
On a related matter, I support Gov. Edwards and the Louisiana Department of Health in increasing Medicaid reimbursement rates, especially for primary care providers and certain specialists. Hospitals already experience payment shortfalls when treating Medicaid patients. North Oaks receives only $0.38 cents for every dollar of health care costs provided to Medicaid patients. Yet, some legislators continue to push for fewer dollars for the Medicaid program. This is simply not a sustainable reimbursement model. If additional cuts are made, hospitals like North Oaks will be forced to make difficult decisions about the types of services we can afford to offer.
Additionally, we are watching closely as the federal government talks about moving Medicaid funding to block grants for states, which potentially could have even a greater negative affect on our reimbursement. Past proposals would have resulted in fewer dollars for states to fund Medicaid, which would mean reductions in services, cuts to reimbursement rates and even rationing of care or waiting lists for patients.
I commend Gov. Edwards for his leadership in expanding Medicaid in Louisiana, allowing us to bring our federal tax dollars back home to provide better care for our residents, and look forward to working together for a healthier Louisiana.
Michele Kidd Sutton, FACHE
President/chief executive officer
North Oaks Health System