Obamacare changes bring uncertainty for area

Published 2:00pm Wednesday, October 2, 2013

Co-pays, deductibles, reimbursements and network exchanges – just a few of the words swirling around, leaving many confused about the new Affordable Care Act.

Uncertainty seems to rule the day when it comes to changes to health care that began with the opening of insurance exchanges Tuesday, Oct. 1, and the Affordable Care Act, commonly referred to as Obamacare, has many health care professionals taking a wait-and-see approach when it comes to any immediate answers.

Chief executive officer of King’s Daughters Medical Center, Alvin Hoover, is taking a month-by-month approach at his hospital, and remains cautiously optimistic.

“There’s still a lot of confusion. The key for us is to remain as resilient as possible. The act is the law, and so we are bound by it,” Hoover said.

As it stands, KDMC generates hospital revenue on a percentage basis. Up until this point, the hospital received approximately 20 percent of its revenues from Medicaid, the government-run health plan for children, pregnant women and other residents who fall within a particular economic qualifier and that have serious health issues.

Medicare, on the other hand, represents the largest share of money coming in for the hospital, generating upwards of 45 percent of overall revenue, said Hoover.

Last year, roughly 12 percent of admitted patients that were treated did not have any healthcare insurance, and, according to Hoover, the hospital typically collects 10 cents on the dollar in these cases. This year, the hospital expects to see about nine percent of revenue from uninsured patients, notes Hoover.

The rest of the revenue comes from commercial insurance providers such as Blue Cross or Aetna, to name a few, Hoover said.

The hospital CEO has diminished expectations of the health care changes, partly due to Mississippi’s recent decision to not expand Medicaid coverage.

For the time being, or until Mississippi authorities meet again on the matter, state officials have made the decision to not expand Medicaid, which would have broadened the umbrella for currently uninsured low income Mississippians.

“Since the expansion of Medicaid is such an integral part of Obamacare, our state’s decision to not implement these changes will have a serious effect on state hospitals, including King’s Daughters Medical Center,” Hoover said.

Hoover says he looks forward to an influx of newly insured Mississippians, as mandated by law, however, certain state-related factors will play a role.

For one, recently released information from the Department of Health and Human Services Department suggests that Mississippi premiums are expected to be among the highest in the nation. This corresponds directly with two dismal factors: the poor health of Mississippians and poor income as well.

Furthermore, Mississippi Insurance Commissioner Mike Chaney mentioned another concern in the state, anemic competition among insurers. “We suffer from a lack of competition in the state in the health insurance marketplace, which does not help to bring insurance rates down,” said Chaney at a recent meet and greet at Co-Lin Community College.

According to the DHHS, nearly 20 percent of Mississippians currently do not have health insurance, or 511,758 state residents. While the affordable care act suggests these folks will be eligible for marketplace insurance, it remains difficult to predict a specific amount. It remains nearly impossible to know then, how this might affect KDMC, said Hoover.

“We hope it’s going to be a good thing. We have high hopes at the hospital, but it’s too early to tell how many newly insured patients will result in our area,” he said.

Among a number of unanswered questions that remain is the number of people who intend to stay with their company’s healthcare plan, if offered, and the number that will switch to an open market insurer.

In the short run, Hoover does not anticipate the necessity of having to lay off any employees due to changes in health care policy at King’s Daughters Medical Center, but mentions there could be a re-evaluation of staffing assignments if and when an employee chooses to leave in the near future.

With the number of questions growing exponentially day-to-day, Hoover suggests that concerned citizens contact their local insurance representative or a financial counselor at the hospital for help with their questions. He also suggested contacting church representatives and elders on the matter.

“Church members know a lot about these issues, more than most people might think.”

There is also a great deal of information online, in particular at state insurance commissioner Chaney’s website.

In addition, general information about the new changes, and their relevance to the state of Mississippi can be found at the Department of Health and Human Services’ website.

“We intend upon making it work at King’s Daughters Medical Center as smoothly as possible,” Hoover said.

In related news, Brookhaven city officials made calculations in anticipation of the affordable health care act provisions at an aldermen’s meeting in late August. The board estimated additional city expenses of roughly $48,000, according to Mayor Joe Cox and City Clerk Mike Jinks.