Proposed Medicare cuts could further hurt elder care in Arkansas

by Luke Mattingly (lmattingly@carelink.org) 592 views 

It has been a tough year for those of us who provide community care and home care for older Arkansans. Changes in federal and state regulations, the latter being ensnared in legal tie-ups for much of the year, have reduced services for seniors and a slow bleed of resources from CareLink and similar organizations. In our case, it has also meant lost jobs.

We are working with state leaders to find the best outcome for our clients, but there do not seem to be any easy answers in the immediate future.

In addition to advocating for positive change for seniors in Arkansas programs, CareLink is also concerned about changes that occur at the federal level. The Centers for Medicare & Medicaid Services (CMS) are considering a new rule for 2019 that would significantly cut Medicare funding for outpatient services performed at our local hospital clinics. If enacted, this rule could threaten hospitals’ ability to provide around-the-clock access to emergency care, which can jeopardize the health of our clients and other vulnerable citizens.

The proposed CMS rule would expand Medicare’s use of so-called site-neutral payments, reducing payments to hospitals that treat Medicare patients in hospital owned outpatient clinics. Our hospitals could see a 60% cut in Medicare payments for outpatient services, a loss of $760 million in funding every year nationwide. This would create a drastic reduction in senior care options that would be felt in Arkansas communities, particularly in our rural communities where hospital clinics are often the only option for medical care.

While this rule is promoted as an effort to curb costs, it will only save the average Medicare patient $14 in copayments per visit while threatening their longer-term access to health care. The change would hit Medicare patients who already face a greater risk of developing serious health conditions the hardest.

Community providers rely on hospitals to provide essential services not only to our elderly clients, but to lower-income families that may otherwise be unable to access this health care locally. Compromising the integrity of this system would create terrible losses for our clients and our communities.

CareLink works daily to improve public health. We offer information and assistance and provide services for older Arkansans as well as partnering with researchers and institutions to help improve our understanding of the health issues our clients face. Ensuring that Arkansans have unfettered access to the health care services they need is a huge concern for me, both as the head of CareLink and personally through the many relationships I’ve developed over the years through our work.

If this rule is passed and Medicare funding to hospitals delivering outpatient care is cut, it will potentially devastate the health care landscape here in Arkansas and across the country. Community providers like CareLink and our hospital partners are part of the central foundation of our communities, not only for their care, but also by creating local jobs and strengthening local communities. We should not be making any Medicare or Medicaid cuts that would weaken their ability to maintain that role.

Arkansas has often been a national model for strengthening and improving access to health care. I trust that our federal representatives and state leaders will urge CMS to re-consider changing these Medicare reimbursement rates. The proposed one-size-fits-all approach CMS proposes will threaten local hospitals’ ability to serve our communities and treat some of our most at-risk citizens, putting real lives in danger. I know personally how terrible that would be for thousands of our older friends and family members in Arkansas.

Editor’s note: Luke Mattingly is CEO of CareLink, a non-profit home care and community care provider in central Arkansas. The opinions expressed are those of the author.

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