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The voices of individual physicians and physician assistants are crucial in informing the decisions made at the state and federal levels.

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The expertise, experience, and perspective of physicians and physician assistants practicing in Washington is crucial to helping to inform our advocacy on your behalf. And, it's often crucial in helping to inform legislators' decision-making on policy being debated at the state and federal levels.

On this page, we'll highlight some of WSMA's top advocacy priorities where lawmakers need to hear from physicians and PAs directly.

WSMA Action Center

 

Action Alert: Medicaid Professional Services Rate Increase

The WSMA is also urging all of medicine to join us in advocating for the state to increase Medicaid payments for all physicians. In the coming weeks preceding the 2023 state legislative session that begins in January, we need our members to reach out to your local legislators to urge their support. Learn more about how to schedule a meeting with your legislator. Feel free to use the information below to help inform your ask.

Our ask:

Improve access to care for Washingtonians enrolled in Medicaid by supporting an increase in Medicaid reimbursement rates for professional services to the equivalent paid by Medicare, adjusting to inflation moving forward. The estimated fiscal impact for the 2023-25 biennium is $200.4 million to the state's general fund, leveraging a more than 2:1 federal match for an overall investment of $634.8 million.

Studies show that raising Medicaid reimbursement rates is the most effective method of increasing physician and health care provider participation in Medicaid networks. Prioritizing a broad-based Medicaid reimbursement rate increase will improve access to care for Washingtonians by expanding physician participation in Medicaid networks at a time when it is desperately needed and long overdue.

Without access to quality health care services, preventable emergency room visits increase as Washingtonians are forced to seek out episodic care, and health outcomes worsen. These patterns exacerbate health disparities, which have already been magnified by the pandemic.

Background:

The ACA Medicaid expansion and state-level program changes have led to dramatically increased Medicaid eligibility, but it has been at least a dozen years since there has been a broad-based Medicaid reimbursement rate increase. The rate increases funded by the Legislature in 2021 for primary care, behavioral health, and pediatric services were widely recognized as a first step in addressing a long-overdue shortfall in Medicaid rates because all specialties are impacted by low Medicaid reimbursement rates. Patients with cancer diagnoses, joint replacement needs, and other specialty services also deserve timely access to high-quality care.

Our state receives the lowest federal contribution for Medicaid rates (FMAP) and only two states reimburse specialty health care services at lower rates. When the state allocates funds toward Medicaid reimbursement, the federal government contributes significant matching funds, stretching the impact of state-level investments. While the WSMA is thankful for the targeted investments previously allocated by the Legislature, Medicaid rates need to be increased across the board for all specialty services to truly improve access to care.

Physician practices, medical groups, and hospitals, like the rest of the economy, are struggling with high inflation. They are also under enormous pressure to catch up patients on care that was delayed or unchecked and worsened during the pandemic with a workforce that has been depleted. But while other sectors of the economy may increase prices to address the economic downturn and inflation in order to meet demand, physicians providing care for patients on Medicaid are at the mercy of the Legislature and the state's budget.

Impact:

Physicians want to be able to care for all patients, including those on Medicaid. But financial pressures yield limitations on their ability to do so, and financial viability is strained when they do. If Medicaid reimbursement doesn't cover the cost of delivering care, physicians have to limit the number of Medicaid patients they serve or risk jeopardizing their ability to keep their practice doors open.

Medicaid enrollment in our state stands at over 2.2 million, representing nearly 30 percent of our state's population and an increase of around 400,000 since the beginning of the COVID pandemic. Making matters worse, many people delayed seeking necessary medical care throughout the pandemic, resulting in patients presenting in clinics and health care facilities with more acute conditions. It's more important than ever that all residents of our state have access to specialty medical care.

Medicaid disproportionately serves families of color, low-income communities, and children - meaning that these patients disproportionately face difficulty accessing timely, cost-effective care. Medicaid is one of the primary avenues of health coverage for residents of our state and it's imperative that the state help ensure access to care for all of our state's residents by adjusting reimbursement rates to more accurately reflect the cost of delivering care.

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