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Health care providers hope Medicaid rate increases remain in final N.H. state budget



Valley News Staff Writer
Tuesday, August 13, 2019

LEBANON — Health care providers in the Upper Valley and other areas of New Hampshire say the state’s low Medicaid rates make it difficult for them to recruit and retain workers, so they’re hoping that across-the-board increases survive the final version of the state’s two-year budget.

A group of more than 40 providers and advocates from across the state teamed up to form the New Hampshire Health Care Workforce Coalition and successfully lobbied the state legislature to include 3.1% increases in Medicaid rates for this year and next, for a total of $60 million, in the budget passed in the spring. Though they had originally hoped for about twice as much, providers agreed that this was a first step toward stabilizing their workforce.

“Every little bit helps,” said Suellen Griffin, CEO of the Lebanon-based West Central Behavioral Health, a community mental health center where about 80% of clients are on Medicaid.

Steady increases now and in the future would make it easier for West Central to plan for regular raises and retirement matches for employees, which Griffin said would help reduce the more than 20% turnover rate West Central and the state’s other community mental health centers see each year.

“Eventually it will have an impact,” she said.

But Gov. Chris Sununu’s June veto of the legislature’s $13 billion budget means the fate of those 3.1% increases is uncertain. Sununu and Department of Health and Human Services Commissioner Jeffrey Meyers have said they don’t think across-the-board increases are the way to go because some providers have seen increases to their Medicaid rates outside of the budget process.

For example, Meyers, in a June letter to legislative leaders, pointed to other increases for mental health and addiction treatment, as well as an increase in Medicaid payments to hospitals required by a court decision last year.

In an emailed statement Tuesday, Sununu criticized the legislature’s budget, saying it includes “sweeping, across-the-board increases that will bloat administrative health care bureaucracies.”

Instead of the broad increases, Meyers and Sununu have proposed giving Meyers and his department “authority to target increases to services in order to find the most equitable balance,” Sununu wrote in an Aug. 8 letter to the Health Care Workforce Coalition.

DHHS would do so based on an analysis of current and historical rates, DHHS spokesman Jake Leon said in a Tuesday email.

Given that West Central benefited from rate increases for some services last year, Griffin said she is worried that West Central could lose out if DHHS determines mental health agencies have already gotten an increase and don’t need another.

State Sen. Cindy Rosenwald, D-Nashua, who sits on the Senate Finance Committee and proposed the original bill including the higher rate increases, said leaving it up to DHHS to determine who gets Medicaid increases would leave the door open to favoritism.

“We’re not overpaying any of our providers,” she said.

Health care providers said it’s the entire system that is struggling under the state’s current Medicaid rates.

Martha Ilsley, administrator of Hanover Terrace — where as at all the state’s nursing homes there is an approximately $50 gap between the daily cost of care per patient and the Medicaid rate — said she frequently gets calls from patients who need a nursing home bed because they can’t find the Medicaid-supported services they need in order to stay at home.

“We need to look at Medicaid reimbursements to all of us,” Ilsley said. “We’re all affected.”

Sununu is not completely opposed to the 3.1% across-the-board increases, his spokesman Benjamin Vihstadt said in a Tuesday email, but he’s leaning on legislators to find “other ways to deliver a budget that does not contain a nearly $100 (million) structural deficit nor raise taxes.”

Nora Doyle-Burr can be reached at ndoyleburr@vnews.com or 603-727-3213.