Thousands of our most frail, elderly Texans — and the physicians who care for them – are still waiting for our state to solve a medical emergency it created for them nearly four years ago.
During the 82nd Texas Legislature, lawmakers made a number of funding cuts without knowing their complete impact. Those cuts left thousands of dual-eligible Texans and their physicians in a serious bind. “Dual-eligible” patients are low-income seniors and people with disabilities who qualify for both Medicare and Medicaid.
I take care of dual-eligible patients and have for more than 25 years. They make up a large part of my practice, which I used to share with two other physicians. We were all working comfortably and happily in our community, but as our Medicare payments declined, coupled with the state withholding all or part of the Medicaid payment for the care we provide to dual-eligible patients, our successful practice started to unravel.
Most of our dual-eligible patients have complicated health problems. We took time with our patients and addressed all their health concerns in one visit, which takes longer, but it’s worth it. They better understand what I’m asking them to do for their health, and it’s less expensive for our patients to make one trip versus several. However, our practice model was not sustainable, and my two partners were forced to leave in 2013. They couldn’t survive. I’ve been unable to recruit another physician since.
The cuts in the dual-eligible payment devastated my practice and my ability to care for more senior patients in Raymondville. Instead of allowing me to care for them in my office, the state is pushing them into hospital emergency departments, which costs the state and Texas taxpayers a great deal more.
As lawmakers come back to Austin, I call on them to repeal the 20-percent dual-eligible Medicaid cut so physicians can better care for the sickest and most vulnerable people in our state. They deserve it.
Dr. Albert Smith, MD, is a family physician with a practice in Raymondville, Texas. He is a member of the Texas Medical Association.
