With the cuts in reimbursement, increasing preauthorization requirements, and various government hoops to jump through; do you really want another payer with ‘hoops’ and poor reimbursement? The answer is a definite maybe.
If your practice is already experiencing a wait time for treatment, then the answer is most assuredly a no on Medicaid. However, if you are not as busy as you would like to be, then you may want to explore Medicaid as a patient and payer source a bit further.
The first item is to ascertain if Medicaid in your state even covers the treatment of venous disease. Some states do not surprisingly enough. Venous disease treatment is also not a required service under the Affordable Care Act mandates.
Second, if it is covered, then you need to find out what the reimbursement will be.
Third, compare your reimbursement to your variable costs. Your fixed costs like rent, utilities and the like will not change because you saw a Medicaid patient. Your catheter cost to treat the patient along with sclerosing solution, RVT time if contract rather than salaried, and the surgical tray should all be considered when comparing income vs. costs.
If the number is favorable, and favorable enough to meet a reasonable hourly rate for you the physician, then Medicaid may be a reasonable way to gain additional revenues. Two more cautions however…
Do review what the preauthorization process is for the state. In California the process is rather complex adding additional costs (and frustrations!) to the process.
Also check to see if Medicaid in your state has been delegated to various commercial plans. In Arizona you must be a Medicaid provider first, and then you can apply to be a participating provider with the several commercial plans that actually hold the sub-contract.
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