Herndon “Buzz” Jeansonne bought two rural health clinics in Avoyelles Parish back in 2006, when Medicaid paid him $70 to $80 per patient visit. Two decades later, after growing that business into five clinics across Cottonport, Simmesport, Mansura, Marksville and Palmetto, he sold the operation — and now says he probably wouldn't have, if he'd known Louisiana was about to raise reimbursement rates for independent rural clinics like his.
Jeansonne's timing is now at the center of a fight playing out across Louisiana's rural health care landscape. Under Act 859, signed by Gov. Jeff Landry on June 8, independent rural health clinics are getting a $41.50-per-visit Medicaid reimbursement increase this fiscal year, with another $41.50 bump slated for next year pending federal approval, according to a report by New Orleans CityBusiness. Jeansonne still owns the clinic licenses, but he sold the businesses to MyTown Health Partners, a Pittsburgh company backed by Webster Equity Partners that now handles the clinics' billing.
Before the increase, independent clinics were scheduled to be paid between $98 and $129 per Medicaid visit, according to Louisiana Department of Health figures cited in the report. Jeansonne's own clinics — which serve communities with poverty rates ranging from 20% to 50% — were reimbursed between $109 and $125 per visit in 2025 depending on location. The new law aims to close the gap with hospital-affiliated clinics, which were paid between $107 and $587 per Medicaid visit for the fiscal year beginning July 1.
A Legislative Push With a Personal Stake
The rate increase originated with the Louisiana Rural Health Collective, which pushed for the change in the legislature. The group was started by Alec Jeansonne, whose consulting firm works with a large clinic serving 18,000 patients annually and who has said that most independently owned rural health clinics cannot afford to offer employees health insurance. Higher Medicaid rates, according to the reporting, reduce the likelihood that independent clinics will have to sell to larger corporations — the very fate that already befell his father's clinics.
Act 859 was sponsored by Rep. Joe Stagni of Kenner. It passed the Louisiana House Health Committee in a 91-6 vote on May 6 and cleared the full House 95-0 on May 29. Rep. Dustin Miller, a nurse practitioner who joined the legislature in 2016 and co-owns clinics in Opelousas, Port Barre and Sunset that stand to benefit from the increase, voted with the committee to advance the proposal but was absent from the final House vote. Miller has said he avoided involvement in advancing the bill because of a potential conflict of interest and has said he has refused to carry legislation for ethical reasons in the past, though he did not disclose that he could personally benefit from the proposal when it was under consideration, per the CityBusiness report. Miller's clinics will see rates rise from $128 to at least $170 per visit through July 1, 2027, and to at least $211 per visit the following year, pending federal approval.
Hospital Owners Cry Foul
Not everyone is celebrating. Rural hospital owners have said the reimbursement increase gives independently owned clinics a financial edge, and Jeff Reynolds, executive director of the Rural Hospital Coalition of Louisiana, said the increase puts hospital-affiliated rural clinics at a competitive disadvantage. Act 859 also includes adjustments for healthcare-specific inflation moving forward and requires both independent Type 1 clinics and hospital-based Type 2 clinics to undergo state facility need reviews before opening new locations or adding services, a provision aimed at preventing an over-concentration of clinics in any one market, according to FastDemocracy's bill tracking.
The stakes are highest in the state's most remote parishes. Louisiana Department of Health records from 2025 show that 44 of the state's 64 parishes are classified as fully or partially rural, and 73% of state residents live in a primary care health professional shortage area. In Iota, nurse practitioner Nicole Doucet operates the only healthcare provider in town, running four clinics across southwest Louisiana. Her Iota clinic sees about 80 patients a day, serving roughly 1,300 residents, and Doucet has said she cannot compete with larger providers on employee benefits — a gap the new rate increase is meant to help narrow.
Shrinking Medicaid Pool Raises the Stakes
The rate hike arrives as Louisiana's Medicaid rolls are contracting sharply. The state has lost around 200,000 people from its Medicaid rolls over the past year, as Gov. Landry has increased efforts to remove enrollees, according to the CityBusiness report. As the patient pool shrinks, independent health clinics will receive a larger share of available Medicaid funding — even as the program faces further cuts over the next two years following Congress's approval of President Donald Trump's One Big Beautiful Bill Act. Healthcare advocates worry more Louisiana residents will end up without insurance as a result. The American Hospital Association has reported that the coming Medicaid reductions are expected to be particularly severe for rural hospitals.
The financial pressure is not new to Louisiana's rural clinics. Buzz Jeansonne, a nurse practitioner in family medicine, recalled that the Affordable Care Act required his clinics to adopt electronic medical records in 2010, a mandate that cost several thousand dollars to implement. Nurse practitioner compensation at some clinics has since climbed from $65,000 to at least $120,000 plus bonuses, reflecting the broader competition for clinical staff in underserved areas.
The current fight traces back further, to when then-Gov. Bobby Jindal privatized Louisiana's Medicaid program in 2012. Louisiana Legislative Fiscal Office estimates from May found that Act 859 will increase state Medicaid expenditures by $41.8 million in fiscal year 2027, split between $25.7 million in state general funds and $15.4 million in federal matching funds, according to the Louisiana State Legislature. That comes on top of a July 2025 increase that raised baseline Medicaid reimbursement for professional providers, including nurse practitioners and physicians, to 85% of Medicare rates — a $258.4 million adjustment that Louisiana Healthcare Connections described as the state's largest general Medicaid provider rate increase in a decade.
Federal Money and a Fragile Safety Net
Louisiana has also secured $208.4 million in 100% federally funded support through the Rural Health Transformation Program this year to modernize infrastructure, retain clinical staff and shift rural providers toward alternative payment models, according to the Louisiana Department of Health. That initiative includes up to $75,000 per clinician in recruitment and retention incentives. Separately, official fee schedule records showed 135 independent rural health clinics operating in Louisiana as of July 2025, compared with 89 hospital-licensed, provider-based rural clinics — the imbalance Act 859 was designed to address.
The broader managed care landscape has also grown less stable. UnitedHealthcare terminated its participation in Louisiana's Medicaid managed care program on March 31, forcing the state to shift roughly 330,000 enrollees to five remaining health plans by April 1, according to Access Health Louisiana. The exit followed state allegations regarding pharmacy pricing transparency. Louisiana had previously managed to reduce its working-age adult uninsured rate to 8% in 2023 — the lowest in the Deep South — largely thanks to its 2016 Medicaid expansion, even as it recorded the nation's highest poverty rate that year, per Stateline reporting.
For clinic owners like Doucet and consultants like Alec Jeansonne, Act 859 represents a hard-won legislative victory after years of watching independent practices absorb lower reimbursement rates than their hospital-affiliated counterparts. But with federal Medicaid caps looming and the state's insured population shrinking, whether the rate increase is enough to keep small rural clinics independent — rather than following Buzz Jeansonne's path into corporate ownership — remains an open question for Louisiana's parish health systems.
