Target increases for health providers; don't go 'across the board'

To The Daily Sun,

We have added layer after layer of bureaucracy to our health care system in N.H. These layers have not brought our citizens closer to receiving care. Governor Sununu and Commissioner Meyers have recommended a targeted approach for provider rate increases. This approach would foster compliance with federal rules, such as “provider payment rates must be consistent with efficiency, economy, and quality of care and sufficient to enlist enough providers so that care and services are available under the plan at least to the extent they are available to the general population in the geographic area.” A generic 3.5 percent for all increase would not.

The across-the-board increase as currently proposed, will not resolve the problem of access to care from less costly providers or settings. We need a thoughtful, targeted approach, to improve access to care. The many differing provider rates have historically not been treated in an across-the-board manner and it would be reckless to do so now without addressing the prior rate inequities.

Provider rate setting generally includes: consideration of the systems needs; the provider's costs including: wages, productivity, benefits; an established and defined methodology; tiers for acuity; etc. Nothing will be considered under the across the board plan, nothing.

There are breaks in the continuum of care, which result in more costly measures being utilized. People are often stuck weeks or months in a costly inpatient setting, while waiting to access community based care or a mid-level care bed which sits empty, while the bureaucracy swirls and churns. The route to access care must be unclogged.

Most importantly, we are talking about people here. This is about affording patients, and their loved ones, the ability to participate in the development of their own plan of care and having those plans honored. This is about ensuring our programs deliver care before unintended consequences are suffered. We can and we must do better.

Caroline Virtue

Canterbury