Managed care issues lead to Public Health Budget shortfall

This coming fiscal year, Butler County Public Health has a $100,000 shortfall in their budget, as realistic expectations of reimbursement from Medicaid have been cut from $300,000 to $200,000. This deficit is compensated for by taxpayer dollars, as the county sub fund transfer to balance the budget will be increased from $157,113 in Fiscal Year 2019 to $271,347 in FY 20.
     The shortfall in Medicaid reimbursement, according to Public Health Director Jennifer Becker and the Butler County Supervisors, is due to (a) Managed Care Organizations (MCOs) reducing services and denying patients care that Becker and her nurses feel patients need, and (b) even when care is approved by the MCOs, the MCOs are denying claims and/or give partial and late payments. Staff has to spend approximately 10 hours a week attempting to procure reimbursement from the MCOs.
     “The MCOs are very difficult to deal with and receive payments from. It definitely puts a strain on not just our county, but all counties and healthcare systems as well. With the MCOs not paying timely or not paying at all, the county needs to cover the cost of the expenses it takes to provide proper care for our citizens,” said Supervisor Greg Barnett. “It’s definitely a stress on the budget, but it comes down to taking care of our people. And the only way to relieve any budgetary stress is to not provide care for the people that need it. For me that is not an option.”
     Home Health is the service affected by issues with MCOs, as nurses work to provide Medicaid patients with skilled home health services, generally a much less expensive alternative to care in a nursing home.
 
Read more in the February 28 edition of the STAR or TRIBUNE.
 
 
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