A policy change for Medicaid reimbursements to hospitals is expected to encourage more facilities to pursue residency programs in hopes to end Mississippi’s doctor shortage.

The move is the result of a collaboration between the Mississippi Division of Medicaid and the Office of Mississippi Physician Workforce, a state agency created in 2012 with a mission to recruit and retain doctors.

Medicaid reimbursements to hospital residency programs in the past have been based on inpatient discharges.

But insurance companies and Medicaid and Medicare officials are pushing hospitals to do more outpatient procedures, which made the Medicaid payments unpredictable, said Rep. Sam Mims V, R-McComb, who is chairman of the House Public Health Committee.

Now reimbursements will be based on the amount of residents each program has.

“For us to expand and to increase residency programs, (the Division of Medicaid) had to change payment model,” Mims said.

He called the change “nothing but positive” for hospitals and the state.

“It’s going to encourage hospitals to have more residency programs,” he said.  

Mims, who wrote the legislation that created the Office of Mississippi Physician Workforce, said the end result of the change should be more qualified local doctors practicing in underserved Mississippi, hopefully long after they complete their residency.

“Those residents are more likely to stay in Mississippi and to stay in this region of Mississippi,” he said. “If we can create a residency program in the Delta, those residents will stay in that part of the state.”

According to the American Association of Medical Colleges, Mississippi’s number of primary care physicians rose from 1,891 in 2012 to 1,925 in 2016, representing 63.4 primary care physicians per 100,000 people in 2012 compared to 64.4 per 100,000 in 2016.

Mississippi ranked 50th compared to other states in both years.

The Division of Medicaid supports seven residency programs around the state and three others are pursuing accreditation.

A government estimate shows the policy revision is expected to raise the current number of 644 residents in those programs by 73 or by fiscal year 2021.

Southwest Mississippi Regional Medical Center will soon have its own residency program, CEO Norman Price said. Through a new affiliation with the University of Mississippi Medical Center, Southwest hopes to expand its clinical offerings, and the residency program will complement that.

Price said Southwest will eventually have 18 residents working at the hospital.

He said the residency program will begin in January 2021 with six residents, “and we’ll fill six each year until we have 18.”

The residents will earn about $54,000 per year, with their salaries being completely paid trough the Office of Mississippi Physician Workforce, Price said.

“We’re going to have a family practice residency here and the state’s helping us with it,” he said. “It’s going to be zero-budget for us.”

Price said the change in reimbursements with residency programs will be good, agreeing with the notion that basing them on inpatient discharges is a flawed practice because it skips over outpatient services and readmissions.  

As for the premise of keeping doctors in the area, Price said he’s optimistic.

He is retiring in January but will continue to work for the hospital as a consultant in physician recruitment.

“Hopefully some of them will stay,” he said.

Price said new residents will be part of a state program that collects patient data on morbidity indicators such as obesity, diabetes and hypertension.

“We’re going to try to get patients in those programs to prevent future hospitalizations,” he said.

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