Health Equity
Medicaid Enrollment Touches 39% of the Residents of The District of Columbia; DC’s 70/30 FMAP is Vital for the Maintenance of Health & Human Services
A reduction in the District’s FMAP would not lead to long-term government savings and would have a ripple effect throughout the entire health system in the DMV, crippling access to care for not only Medicaid beneficiaries but also all those who live, work, and visit the District of Columbia, including members of Congress and their staffs.
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Why does DC receive an Enhanced FMAP Rate?
The DC FMAP rate of 70% established by the Revitalization Act resulted from bipartisan analysis, discussion, and negotiation by Congressional leadership aiming to balance fairness with the District’s restricted ability to generate revenue. Congress recognized that the District of Columbia faces unique financial challenges due to its non-state status and the significant amount of federally-owned land within its boundaries. The District is unable to tax non-residents’ earnings, so these workers pay no taxes to support the infrastructure and services, such as roads, public safety and emergency services that they benefit from in the District. The District is also unable to tax up to 40% of the real property within its borders due to statutory restrictions.
Why are we concerned about DC's FMAP now?
Members of Congress have proposed reducing the DC FMAP to the statutory minimum for all other states, which is currently 50% (but could be reduced even more). Such a change would impact every physician and every practice, regardless of type, location, and payers contracted. Even practices who take no insurance will not be able to send patients for specialist care, hospital admissions, or other types of care.
What can MSDC members do?
- If you know a member of Congress or staffer, reach out to them and share how DC cuts will hurt your patients.
- Share your relationships and outreach with hay@msdc.org so we can help coordinate advocacy efforts.
- Email hay@msdc.org if you would like to be paired with a physician member of Congress office and trained by MSDC staff on how to reach out.
Resources
- DC FMAP cut fact sheet
- California Medical Association fact sheet on Medicaid cuts
- MSDC and healthcare association letter to Congress arguing against DC FMAP changes.
- MSDC original story on Medicaid changes.
News, Statements, and Testimony on Health Equity Issues
MSDC Promotes Focus on Wellbeing and HEART to Prevent Physician Suicide
Today, the Medical Society of the District of Columbia recognizes NPSA Day, or National Physician Suicide Awareness Day, as a reminder that physicians have one of the highest suicide rates of any profession. More than half of physicians and medical students, and nearly half of residents know of a physician or colleague or peer, respectively, who has ever considered, attempted or died by suicide. In a call to action, MSDC urges a focus on wellbeing-oriented actions and understanding the HEART vital signs so that physicians’ noble work and struggles do not become mental health emergencies.
The overall state of physician wellbeing remains low.
- For the fourth year in a row, six in ten physicians often have feelings of burnout, compared to four in ten before the pandemic in 2018.
- Nearly two-thirds of medical students report withdrawing from family/friends/co-workers, as well as 54% of residents and 38% of physicians.
MSDC President Dr. Ashesh Patel said, “We all have a role to play in preventing physician suicide. Learn the suicide vital signs, check in with a physician, share suicide prevention resources, and together we can prevent physicians’ struggles from becoming crises. If you or a physician you know is in a crisis, please call 988!”
Physician suicide can be addressed through individual and system actions to better support physician mental health and wellbeing. On this day of action, it is important to know what to look out for and potential solutions to address the devastating impact of physician suicide.
VITAL SIGNS: WHAT TO LOOK FOR
Understand and note the warning signs of someone who may be suicidal. Vital signs can be summarized the HEART acronym:
Health
(Increasing the use of medications and/or alcohol or illicit drugs; Talking about wanting to hurt themselves or die)
Emotions
(Experiencing extreme mood swings; Feeling hopeless or having no purpose)
Attitude
(Being negative about professional and personal life; Having inappropriate outbursts of anger or sadness)
Relationships
(Withdrawing or isolating themselves from family, friends and coworkers; Talking about being a burden to others)
Temperament
(Acting anxious or agitated; behaving recklessly; Being uncomfortable, tired or in unbearable pain)
SOLUTIONS TO BOOST WELLBEING AND REDUCE RISK OF PHYSICIAN SUICIDE
Burnout and barriers to care for current and future physicians can cause more cases of depression, anxiety, post-traumatic stress disorder (PTSD) and can lead to suicidal thoughts for physicians. According to The Physicians Foundation, physicians, residents and students have identified what they need to improve their mental health and wellbeing. These include:
- Get mental health resources in the hands of current and future physicians
- Remove intrusive mental health questions from licensing and credentialing applications
- Take action to create a culture of wellbeing in medical schools, residency programs and workplaces.
MSDC’s Healthy Physician Foundation offers resources to bolster physician wellbeing. These include peer coaching and counseling, social events, the Physician Health program, financial wellbeing. and more. For more information and access to resources, visit http://www.healthphysician.org.