State agency cuts rates for most medical providers
Tina Seiler wept as she begged the Oklahoma Health Care Authority not cut funding for the Moore facility where she lives.
Seiler is one of eight residents of Santa Fe Place who attended the OHCA board meeting on Thursday afternoon to plead for continued funding. She said she had lived in foster care most of her life and had no family to stay with if the facility closed.
“I really love the place I live,” she said. “I love my family and my friends. If you cut them, I’d have no other place to go.”
Jessicia Smith, quality assurance director at Santa Fe Place, said the cuts alone won’t force them to close, but they could jeopardize the facility’s ability to meet all the state’s standards for staffing, medical screenings and community involvement.
“The standards aren’t changing along with the budget,” she said. “They’re going to have to cut back on the standards if they’re not going to give us the money.”
Health Care Authority board Chairman Ed McFall said the members didn’t want to vote for the cuts, but have a constitutional duty to balance the budget. He held up a list of lawmakers who voted against a proposed revenue package yesterday and urged the roughly 20 observers to contact their representatives. “This is the meeting we didn’t want to have,” he said. “We have three days to contact these people and try to persuade them to change their vote.”
The board voted to cut 4 percent from long-term care facilities, including those serving people with disabilities, and 9 percent from most other providers who see patients insured by SoonerCare, Oklahoma’s Medicaid program. The cuts come into effect Dec. 1, though the board has scheduled a meeting for early December in case lawmakers appropriate enough money to rescind the cuts.
The state faces a $215 million budget gap after the Oklahoma Supreme Court struck down the $1.50-per-pack cigarette tax. About $70 million of the cigarette revenue was designated for OHCA, which oversees the state Medicaid program.
The combined cuts will save the state $34.7 million, which appear to close the Health Care Authority's budget gap when combined with about $36 million in one-time savings and various smaller reductions. The cuts also will cost providers $49.2 million in federal funds. Medicaid is a state-federal partnership, and Washington matches a certain percentage of the money each state spends on care for eligible people. When the state spends less, it receives fewer federal dollars to distribute to providers.
Most SoonerCare providers absorbed rate reductions of 3.25 percent in April 2010, 7.75 percent in July 2014 and 3 percent in January 2016. Some have raised the possibility that they’ll stop seeing Medicaid patients, or at least quit accepting new ones.
One nursing home already has blamed the new cuts for its decision to close. Keeping Wynnewood Care Center open had been a tough balancing act for years, as funding failed to keep pace with rising costs, operator Bart Reed said. The 4 percent cut was the final straw, however, for the facility, which is owned by the city of Pauls Valley, he said.
Smaller facilities don’t have the economies of scale that larger ones do, and tend not to have enough private pay and Medicare patients to offset low Medicaid rates, Reed said. He says he has two other facilities that are “on the fence.”
“Our food costs alone have outpaced our reimbursements (growth) for years,” he said.
All the residents were able to move into other homes, and the staff who didn’t mind traveling took new jobs at other facilities he runs, Reed said. Still, it isn’t ideal for residents to have to leave their home communities, he said.
“We just couldn’t make it viable anymore,” he said. “The cost to provide care keeps going up and up and up and our (Medicaid) rate has been stagnant for years.”