Reimbursement Rates, MCOs Still Main Issues for Texas Medicaid Providers

TDMR is releasing the results of its 2017 Medicaid Provider survey today.

Not much has changed

Not much has apparently changed for Medicaid providers from 2016. per the 337 individuals who answered our anonymous, 6 question survey in October and November.  Roughly comprised of 28% dental, 20% medical, 15% mental health,  12% home care, 9% behavioral/speech and 15% others, reimbursement rates and problems with MCOs (managed care organizations) continue as the two biggest challenges still facing providers, unchanged from 2016.

Except for a small but noticeable increase in the number of providers concerned about coming under audit by the Texas HHS Inspector General and MCOs, the results are virtually identical to 2016.

Likely to get worse in 2018

There is not much else to add except that one can only assume that with the uncertainty surrounding the continuation of CHIP (Children’s Health Insurance Program), it is unlikely that reimbursement rates will increase or that MCOs will become easier to deal with in 2018.  In fact, the opposite is likely true – finances will tighten even more on providers.

Will distribute results

TDMR will be passing these results along to officials at Texas HHS and the Texas Legislature.

Thanks again to the professionals who took the time to participate in the survey.

Feel free to download (click the download button in the toolbar below) and pass along the results to others.