As costs rise and Medicaid payment erodes to inflation, physicians and other health professionals must make the tough decision to leave the program in order to survive economically. Medicaid and CHIP are two of the primary insurers in most border and rural counties. Low reimbursement rates undermine efforts to retain and attract new physicians and other health care professionals to the region. This situation not only undermines patient access, but a community's overall ability to attract and retain other employers. An insufficient provider base undermines Texas' ability to improve Medicaid children's access to Texas Health Steps, despite a Federal court's direction to do so.
Low reimbursement is the most commonly cited reason that physicians decline to participate.
Simplifying Medicaid eligibility without simultaneously raising reimbursement rates will strain existing pediatric providers' ability to deliver high quality, timely care to children. Health care service providers are often one of the largest employers in a rural community, generating jobs and a strong tax base. Physician practice or hospital closures could economically cripple rural Texas communities. CHIP draws additional funds. Acknowledging the connection between Medicaid reimbursement levels and patient access to care, the Texas Department of Health included within its 2002-2003 budget a request for a 6 percent increase in fees for professional and outpatient hospital services.