O&P Profession Faces Challenging Medicaid Pressures, Cuts

LAS VEGAS – According to Peter W. Thomas, JD, general counsel for the National Association for the Advancement of Orthotics & Prosthetics, there are relatively few people on Capitol Hill discussing Medicaid and its fiscal impact on the United States. There are even fewer people discussing the pressures on Medicaid and its effect on the O&P profession.

“The Medicaid program is the third largest entitlement program after Social Security and Medicare,” Thomas told the audience at the 2011 American Orthotic & Prosthetic Association (AOPA) National Assembly here. “And it is catching up to Medicare.”

State legislators must provide coverage for Medicaid beneficiaries while struggling with their state’s declining revenue. As states grapple with reduced revenue, there is an ever-growing population who qualify under the current eligibility criteria for Medicaid. There will be even more pressures on the program as the increasing number of unemployed and low income individuals qualify for Medicaid. Currently, Medicaid covers 60 million Americans, including 8 million people with disabilities. According to Thomas, those numbers could increase dramatically due to the Patient Protection and Affordable Care Act (PPACA). It is estimated that in 2014, the PPACA could increase the number of Medicaid beneficiaries by 16 million. This in turn, places more pressures on the states to figure out ways to reduce their expenses. One of the possible cuts for Medicaid beneficiaries is orthotics and prosthetics.

“The serious financial pressure of Medicaid at the state and federal level will be in place for years to come,” Thomas said. “The impact on O&P is going to be relatively non-specific at the federal level, but quite specific at the state level.”

Thomas said he does not believe there will be O&P specific proposals in the joint committee’s recommendation on how to cut Medicaid or Medicare expenses. This is because the O&P profession is simply too small to receive serious attention during the joint committee’s recommendation on how to cut $1.5 trillion from the federal budget during the next 10 years.

“Our fiscal problems are so broad and enormous that they cannot get any impact from O&P,” he said,

At the state level however, Thomas said the O&P profession is at significant risk for cuts, and numerous O&P organizations, including AOPA are working tirelessly to stave off these risks.

“We use the argument that quality O&P care keeps someone highly functional, employed or eligible to become employed,” Thomas said. “In the long run, states ultimately save money. That is a message that we must continue to express for years to come. But the next several years are going to be extremely challenging because of these fiscal problems.”

Thomas PW. The Medicaid crisis and how it could impact you. Presented at the 2011 American Orthotic & Prosthetic Association National Assembly. Sept. 19-22. Las Vegas.

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