Star-Tribune Editorial Board

Casper's Western Medical Associates did the right thing when the practice decided it would not opt out of the Medicare program.

Because of low reimbursement rates under the federal program, Western Medical announced two weeks ago that pending negotiations, it would stop seeing Medicare patients on Sept. 1. The same held true for patients with Blue Cross Blue Shield and military veterans with Tricare insurance.

Combined with a plan to opt out of Medicaid on Oct. 1, the proposed action would have had a devastating effect on health care in the community. An estimated 15,000 patients would have lost their access to medical care.

That was a frightening thought for patients, particularly older ones covered by one of the federal programs, who may not be able to afford other health insurance. A large percentage of those dropped would likely have had to turn to the Wyoming Medical Center's emergency room for their care.

Western Medical made its decision to keep treating Medicare patients, even though the practice was not successful in its effort to raise federal reimbursement rates, which are locked in. Its only options are to change its Medicare billing practices to see if it can recoup more reimbursement, or maintain the status quo.

It's important to note that when faced with a difficult business decision, Western Medical ultimately chose its patients over money. That's commendable.

There's good news to report with the other insurance programs as well. Western Medical CEO Richard Blauvelt said the practice will probably stay with Medicaid, and has scheduled another meeting to discuss reimbursement rates with Blue Cross Blue Shield.

(Full disclosure: Blue Cross Blue Shield is the Star-Tribune's health insurance provider.)

Meanwhile, people covered by Tricare can also breathe a sigh of relief. "We will take veterans and their families even if they don't come to the table. We'll do our patriotic duty," Blauvelt said of the insurance provider.

In announcing its decision, Western Medical also changed its approach to the reimbursement problem facing it and many other Wyoming medical practices. Instead of threatening to stop seeing certain patients, Blauvelt urged Medicare and other patients to rally against low reimbursement rates by writing letters to Wyoming's congressional delegation and creating advocacy groups.

That's a much better way to enlist the aid of patients to help make a difference. Medical professionals deserve to be compensated fairly by federal programs, and we urge our state's congressional delegation to do what it can to improve the system.