Bill would increase medical assistance payments for rural Washington healthcare providers
A bill sponsored by Rep. Jacquelin Maycumber (R-Republic) would establish a pilot project that would increase medical assistance payments for Washington providers in rural and underserved areas.
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Members of the House Health Care and Wellness Committee discussed House Bill 1713 during a public hearing on Wednesday. Maycumber said one of the primary health-related concerns she hears from constituents is about access to care, particularly from those who live in healthcare deserts.
“We talk about healthcare deserts, but what does that mean?” Maycumber asked. “That means that some of the lowest-income people in the state, some of the most difficult for (accessing) transportation, have to drive sometimes two to three hours for access to a healthcare provider.”
Many rural providers say they are often not reimbursed the proper amount for their services, and want more parity, Maycumber said. Those areas often do not have enough providers to meet the demand for services either, as many choose to work in more urban areas where they can make more money, she said.
“It creates a cycle in the reduction of healthcare access,” Maycumber said. “And it’s really important that we note that in a lot of these rural areas, you’re seeing less and less providers come in, and more retiring out.”
HB 1713 would establish a pilot project to increase medical assistance program payments to healthcare providers and facilities that serve a specified number of medical assistance and Medicare enrollees in rural areas, or areas with a high concentration of people who have historically been marginalized and underserved with respect to healthcare access.
Christopher Blake, committee staff, said the pilot project would apply to healthcare providers where at least 50% of their patient encounters are from medical assistance enrollees or Medicare clients.
Under the pilot project, the Washington State Health Care Authority (HCA) would provide a rebalancing (increased) payment to eligible providers on a quarterly basis between July 1st, 2024, and July 1st, 2027, Blake said. The rebalancing payment would be equal to the difference between the provider’s reimbursement attributable to services provided to patients enrolled in medical assistance programs and the amount the provider would have been reimbursed had those services been reimbursed at 100% of the cost based on Medicare reimbursement standards.
“The HCA must submit a report on the results of the pilot project to the governor and the legislature by Dec. 1st, 2027,” Blake said. “The report must discuss how many healthcare providers or facilities received these balancing payments, the average amount received, an analysis on the impact of access to care, and the status of healthcare providers and facilities in the areas of the pilot project.”
The report would also include recommendations for ways to more equitably reimburse providers, Blake said.
“I bring this bill to you to have the conversation of these healthcare deserts,” Maycumber said. “These people struggle with access to healthcare and, unfortunately, go without. This bill is brought to you so we can talk about recruiting healthcare providers in these rural areas, and make sure payments would be equitable [compared to what] you would see in more affluent areas.”
No action was taken on the bill.