A Medicaid rule change could put the Scioto County Community Action Organization's health clinic out of business, its director said Friday.

“We've been here for the county for 30 years,” Christine Eaton said. “They're saying they don't need us anymore.”

The state is in the process of shifting many low-income families who qualify for Medicaid into managed-care programs, which generally pay less in Medicaid reimbursement fees than the state.

Before the change, clinics received more money from Medicaid than they now will. For instance, a Chillicothe clinic used to get a $92 reimbursement for each client. That has now dropped to about $35.

The change has prompted a Ross County clinic to close its doors and left a second clinic in southern Ohio scrambling to find money to stay open.

Eaton said the same fate may await the CAO clinic at 411 Second St. because Medicaid patients who will now use a managed-care program won't need the clinic. Under the program, they will always have medical care.

“Why would they come here if they already have a doctor?” Eaton said. “This will affect us greatly. We can't predict how many clients we will have now.”

That means Eaton cannot predict how much money the clinic will take in either. Therefore, it will make it harder to serve those who cannot afford to pay. Some clients pay on a sliding-scale basis.

The new method also will make the billing process more complicated.

While the change is good for Medicaid clients, it is not good for other low-income clients, Eaton said.

Eaton said she will figure out how much the clinic will collect from paying clients and other sources before deciding what to do.

The CAO clinic operates as a primary-care clinic two days a week. It offers a variety of services the rest of the week.

It started in the 1970s after local doctors would not see Medicaid patients, Eaton said.

The changes will not affect Medicare patients, which are mostly senior citizens. But Eaton said about only 35 percent of CAO clinic patients are on Medicare.

City health commissioner Don Walden said the Medicaid change will not affect the city because it is not yet a primary-care clinic.

The city plans to open the first week of October, according to Primary Care and Prevention Administrator Tim Roe.

Roe said the loss of Medicaid funding already has been figured into the clinic's budget.

The Associated Press contributed to this story.

JEFF BARRON can be reached at (740) 353-3101, ext. 236.