Hope is not strategy for Medicaid fix

Published 12:00 am Wednesday, July 13, 2016

Dear Editor,

Alabama Medicaid Commissioner Stephanie Azar is trying to do the impossible. She is cutting the Medicaid program because of the completely inadequate funding appropriated by the Alabama legislature for FY 2017 while still hoping Alabama will have an effective healthcare delivery system. It does not work that way. Hope is not a strategy.

Azar’s first step is the August 1 reduction of physician reimbursement by eliminating the Medicaid physician “payment bump”, a move that could have significant adverse effects on children and Alabama’s healthcare delivery system. The Alabama Medicaid agency has historically been one of the lowest state-funded agencies in the country.

A healthy, financially stable Medicaid program is vital to the more than 500,000 children served by the program, and it is critically important to the overall healthcare system in Alabama for all children. And it all begins with the primary care pediatricians and family medicine physicians in communities throughout Alabama who are on the front lines of healthcare.

Three-quarters of the Medicaid recipient population is under the age of 18 and account for almost half of the children in our State. For over 45 years, Medicaid has been an important part of Alabama’s pediatric healthcare system. Importantly, Medicaid and commercial insurers provide coverage for 95 percent of our children. This is an outstanding achievement. As a result, the number of pediatricians across the State has increased, and Alabama ranks high in the nation in important child well-being markers, such as access to care, immunizations, timely preventive care and routine care for chronic illnesses. Our front line pediatricians and family care physicians do a great job but now that is all in jeopardy.

Approximately 60 percent of Children’s of Alabama’s patient population is Medicaid-eligible.Children’s is the State’s only comprehensive pediatric medical center and Medicaid is important to our ability to continue to provide care for all of the ill and injured children who come to us from each of Alabama’s 67 counties every year. The children of Alabama desperately need for Medicaid to have stable, long-term funding that can help ensure medical care is accessible and available for all our children and for the next generation to come.

Children’s of Alabama will continue to work with policy and legislative leaders to find long-term, sustainable funding for the State’s Medicaid program. It is imperative that the pediatric healthcare framework not be disrupted and that we are well positioned to address the future needs of our children. The primary care physicians are at the epicenter of care for children in communities throughout Alabama. Their success and viability is simply good for kids.

The UAB Department of Pediatrics has provided, and continues to provide, training for pediatricians who are eager to provide care for the next generation of Alabama’s children. A stable Medicaid program will help us retain these young doctors in our State, particularly in communities where the number of physicians is already low. Fewer community pediatricians will mean more local emergency room visits and increased costs.

Children’s of Alabama, the UAB Department of Pediatrics and our healthcare partners across the State call on our governor, legislators and policymakers to do what is right for children and our medical community. Alabama must stop the annual, one-time band-aid approach to Medicaid funding. Alabama’s children deserve a viable, sustainable long-term solution to Medicaid funding and only the governor and the legislature can do that job.


Mike Warren

President and CEO, Children’s of Alabama


Mitch Cohen, MD

Children’s Physician-in-Chief

Chair of the UAB Department of Pediatrics