CMA goes to Washington, tells CMS to stop the Medi-Cal physician payment cuts and Study looks at economic factors associated with rise in ED closures

CAL/AAEM News Service at
Mon Jun 6 08:36:42 PDT 2011


May 16, 2011
CMA goes to Washington, tells CMS to stop the Medi-Cal physician payment cuts

CMA Alert
Recently, a team of CMA leaders was in the nation's capital to push for action on CMA's federal health reform priorities. The main focus of the trip was to urge the Centers for Medicare & Medicaid Services (CMS) to stop California's 10 percent Medi-Cal physician reimbursement rate cuts.

In 2014, an estimated 3 million uninsured will be newly eligible for Medi-Cal under the new health care reform law. If these cuts are allowed to stand, California will not have the provider capacity to care for these new Medi-Cal patients.

CMA President James Hinsdale, M.D., Medi-Cal physician Margaret Juarez, M.D., CMA Chief Executive Officer Dustin Corcoran and CMA Vice President of Federal Relations Elizabeth McNeil met with high-level CMS officials and members of the California congressional delegation, urging them to reject the State of California's request to reduce Medi-Cal physician reimbursement rates.

CMA warned that the 10 percent rate cut 1) will harm patients and access to care; 2) will cost the state and federal government as much as three times more as patients' conditions worsen and they are forced to seek care in the ER; 3) is inconsistent with federal law, which requires the program to provide the same access to care for Medicaid patients as for the general population; and 4) will severely hinder the successful implementation of health care reform.

Dr. Hinsdale told CMS that "...these cuts would force physicians out of the program, cause irreparable harm to patients, and overwhelm the state's ER system which is already on the verge of collapse."

Last month, Governor Jerry Brown signed budget bills that cut Medi-Cal provider reimbursement rates by 10 percent. It is now up to CMS to approve or deny California's Medi-Cal rate cuts. This week U.S. Health and Human Services Secretary Kathleen Sebelius stated that the agency has not yet made a decision on whether it will allow California to move forward with its proposed cuts, but she did acknowledge that the connection between rates and access is a "critical issue."

CMA also urged CMS to significantly revise the unworkable accountable care organization regulations to make them less burdensome and more attractive for California's medical groups and solo/small group physicians. The CMA team also met with the CMS Innovation Center asking them to fund solo/small group physician projects in California. CMA will be developing several proposals to submit to the Innovation Center, which was recently allocated $12 billion to fund innovative physician payment and health care delivery reforms.

Before leaving Washington, CMA met with the Senate Finance Committee and the health care leaders in the California congressional delegation on other key issues, including Medicare payment reform and professional liability reform.

Contact: Elizabeth McNeil, (415) 882-3376 or emcneil at

May 17, 2011
Study looks at economic factors associated with rise in ED closures

AHA News Now
Hospitals were more likely to close their emergency departments in the past 20 years if they had low margins, safety-net or for-profit status, or were located in high-poverty areas or competitive markets, according to a study in the May 18 Journal of the American Medical Association. Between 1990 and 2009, 1041 hospital EDs closed in non-rural areas, two-thirds of them due to the closure of the entire hospital, the authors found. (The study excluded hospitals in rural areas, which are sometimes designated as critical access hospitals and operate under different federal mandates and supports.) “Our findings expand the evidence base by showing that economic factors related to ED closures are similar to those related to hospital closures and may be even stronger,” the authors write.

Anna Parks &
Brian Potts MD, MBA
Managing Editors, CAL/AAEM News Service

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