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Insurers To Increase Reimbursement To Adirondacks Community Health Centers

Armen Hareyan's picture

Insurers CDPHP and Empire Blue Cross Blue Shield agreed to raise reimbursement rates to health centers in the Hudson Headwaters Health Network, a not-for-profit system of community health centers that provides care for 60,000 residents in the Adirondacks region of upstate New York, the Albany Times Union reports.

According to Hudson CEO John Rugge, the organization faced a $1.5 million budget shortfall because payment rates from private insurers are as much as 30% lower than those from Medicare and Medicaid. Despite the agreement to increase rates, the network is "still in distress. This is health reform in motion, and the outcome is uncertain," Rugge said. He also has asked insurers MVP and BlueShield of Northeastern New York to increase their reimbursement rates, the Times Union reports.

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The requests follow an August summit that was called to address the lack of primary care physicians in the Adirondacks. According to the Times Union, a growing number of physicians are leaving the area for better-paying positions and fewer on-call hours, and efforts to recruit physicians to the area have been largely unsuccessful. Rugge said, "We're looking for ways to continue to provide quality primary care to these underserved populations, but Gov. [Eliot] Spitzer (D) is determined that the state will no longer subsidize private insurance companies and their profit margins." He added, "There's a looming disaster if we don't figure out how to reorganize the dollars in the system" (Grondahl, Albany Times Union, 10/13).

Physician Shortage
In related news, a group of health care experts on Friday lobbied commissioners of the Adirondack Park Agency to bring the shortage of physicians in the region to the attention of Spitzer and other state officials. According to Long Island Newsday, the shortage is the result of a lack of "homegrown physicians" and difficulty recruiting doctors to the region.

Sandra McGinnis, a researcher at the School of Public Health at Albany University, said the northern New York region is the area most affected by the loss of primary care physicians. Experts cited high property taxes, relatively low pay and the need to persuade doctors to live in remote mountainous regions as hurdles to recruitment (Long Island Newsday, 10/13).