Idaho official: There's no problem with access to medical care for Nampa Medicaid patients

adutton@idahostatesman.comOctober 10, 2013 

People in the Nampa area who receive health insurance coverage from the state Medicaid program seem to have no problem finding doctors willing to treat them, according to Idaho Department of Health and Welfare Director Richard Armstrong.

Armstrong testified Thursday in U.S. District Court as part of an ongoing trial over whether St. Luke's Health System violated antitrust laws and harmed competition by purchasing Nampa-based Saltzer Medical Group last year.

St. Luke's attorneys are seeking to prove to Judge B. Lynn Winmill that the acquisition is the only way the St. Luke's system can achieve several goals related to quality of care, lower costs and overall community health.

Jack Bierig, an antitrust attorney hired to represent St. Luke's, asked Armstrong a string of questions Thursday, essentially prompting him to agree that the goals St. Luke's says it will achieve would be good for the state.

Bierig pointed to Armstrong's own goals for the Idaho Medicaid program — moving Medicaid payments from a traditional fee-for-service to an outcomes-based system, for example — as parallel to what St. Luke's is trying to do.

Then Bierig noted that independent doctors have no obligation to take patients insured by Medicaid, which pays much less than private insurance, whereas doctors employed by nonprofit St. Luke's must take Medicaid patients.

Bierig asked whether Armstrong thinks it would be bad for public health if Saltzer physicians, forced to leave St. Luke's and become independent again, stopped taking as many Medicaid patients.

After some prodding, Armstrong said that would have a negative effect on public health.

"Today, we do not have an access issue," Armstrong said, referring to Medicaid patients' ability to access medical treatment. "If there were a decline in the number of physicians who would see Medicaid patients, it would create an access issue for us."

A lawyer for the Federal Trade Commission and Idaho attorney general later asked Armstrong if he knew how likely it is for the St. Luke's acquisition to have various effects on Medicaid, public health and competition. Armstrong said, in most cases, he didn't know.

There was an exception: the idea that independent doctors cannot afford to take Medicaid patients.

"I am aware of some physician practices that have re-engineered their processes," he said. "And I am told they don't lose money on their Medicaid patients."

Thursday was the second time attorneys for St. Luke's have brought in an employee of the state, which is suing St. Luke's through Attorney General Lawrence Wasden, to testify in the trial.

Wasden, the FTC, Saint Alphonsus Health System and Treasure Valley Hospital are suing St. Luke's for alleged antitrust violations they claim will raise health-care prices in the Nampa area.

Audrey Dutton: 377-6448, @IDS_Audrey

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