Low provider payment rates often means fewer physicians choosing to provide health care for persons whose health insurance is provided through Medicaid, the state/federal health insurance program for low income people and those with disabilities. And with fewer medical providers in the system, access to medical services often becomes a problem for persons who are covered for health care in the program.

That fact was acknowledged by the Kansas Legislature when it chose to appropriate an additional $10.4 million to the Department of Social and Rehabilitation Services for the purpose of improving rates paid providers in the state's Medicaid program.

New rates based on the additional appropriation take effect July 1. Decisions on which rates to increase were made by SRS based on input from a task force of medical service providers from across Kansas. The rate increases were chosen for procedures involving prevention, wellness, and outpatients services. In addition, rates for some vision services were increased.

SRS Deputy Secretary Janet Schalansky said for many medical procedures, rates paid through the Medicaid program have not increased since the 1970s. This makes it difficult for physicians to treat persons in the health insurance program which in turn results in a problem for people to get the treatment they need.

Schalansky said the task force of medical professionals created to study provider rates will continue the process and have further recommendations in the future.

The Legislature based its additional appropriation on a study done by Mathematica Policy Research Inc., a research organization based in Washington D.C. The study was funded through a grant by the Center for Health Care Strategies, a subsidiary of the Robert Wood Johnson Foundation.

The study compared rates paid for medical procedures in the Kansas Medicaid program to rates in three different areas: an average of Medicaid rates in Missouri, Iowa, Indiana, and Nebraska; rates paid in the Medicare program in Kansas; and a limited sample of private insurance rates in Kansas.

The study found that Medicaid physician reimbursement in Kansas overall is substantially below that of the other state Medicaid programs, and even further below rates paid by Medicare and private insurance. While there are several areas where rates are comparable to other programs such as rates for pediatricians and obstetrics, most rates are substantially below other states and programs, the study found.

"Kansas rates are especially low for many primary care services, such as hospital and office visits, and immunizations," according to the study.

SRS Commissioner of Adult and Medical Services Ann Koci said the increase provided for physician services was much needed. Koci said the task force looked at prevention-based and outpatient-based procedure codes to determine which most needed an increase.

"In order to provide continued access to medical care for some of our most vulnerable citizens, the increase was necessary," she said.

Page Last Updated: May 29, 2001