Hospitals mull possible impact

Published 5:00 am Friday, June 20, 2008

With less than one week remaining before the Legislaturereconvenes next Thursday to deal once more with Medicaid’s $90million shortfall, the medical community of Lincoln and surroundingcounties is calling on a divided House to unite in support of thehospital assessment plan forged by the Division of Medicaid, theMississippi Hospital Association and the governor’s office.

While leading medical personnel in the area agree that SenateBill 2013 – the legislation proposing the combination of threehospital taxes into one, $167 per day assessment – is not the idealsolution for funding Medicaid, they are calling for itsimplementation to avoid cuts to the program promised by Gov. HaleyBarbour.

Franklin County Memorial Hospital, King’s Daughters Medical Centerand Lawrence County Hospital would all have to pay an increased taxunder the assessment plan; however, all would receive a greateramount of Medicaid reimbursement for those payments. And while theleaders of each hospital agreed some form of tobacco tax would bepreferable in the final Medicaid solution, they also agree thatBarbour’s proposed Medicaid services cuts – which the governor hasscheduled for July 1 if the SB 2013 fails – would put theirfacilities in a crippling situation.

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“We won’t be open but a month or two if the governor goes aheadwith those cuts,” said FCMH Administrator Lance Moak. “We wouldhave to reduce our costs by about $7,000 per week. With the bulk ofour costs being personnel, we’re talking about a pretty drasticreduction in our workforce, with the possibility of a reduction inservices also.”

With last week’s temporary layoffs and reduction of working hours,Moak said FCMH could ill afford any cuts to Medicaid.

Moak said 88 percent of the hospital’s patients are throughMedicaid or Medicare. If the governor makes cuts to the program, hesaid, FCMH would have to make a permanent workforce reduction.

If SB 2013 is passed, however, Moak said FCMH’s Medicaidreimbursements would increase by an amount of $200,000 over lastyear’s totals.

“It would be a blessing if we get this bill passed and get it out,”he said.

Moak pointed out that the blessing might be only temporary,however, as the Medicaid reimbursement figures fluctuate from yearto year. He said SB 2013 is not the best plan, but it is the bestof what is available – and very preferable to any of the threeproposed cuts outlined by Division of Medicaid Executive DirectorDr. Robert Robinson.

“I may be happy with it this year, but I may not like it nextyear,” he said. “But we can’t afford those cuts. They all stink -none of ’em are any good.”

While KDMC is better equipped to deal with tough times than itsFranklin County neighbor, its bigger size and greater revenue willnot prevent it from taking a massive hit from any Medicaidcuts.

“Those cuts would flat out cost us more than $2 million, with nochance of recouping any of that money,” said KDMC Chief ExecutiveOfficer Alvin Hoover. “There’s absolutely no doubt in my mind thatwe’d have to make some drastic decisions. We would have to examineour personnel, supplies, services – everything would be on thetable and we’d have to figure out as quickly as we can what itwould take for us to survive.”

Hoover said KDMC “absolutely” supports SB 2013, noting that it isthe only plan in place to halt Medicaid cuts. The assessment is notthe perfect fix for Medicaid, he said – he would like to see anincreased tobacco tax – but KDMC will see an increased Medicaidreimbursement if the plan is passed.

Under the plan, Hoover said the hospital would have to pay out $1.3million in taxes but would receive approximately $2.3 million inMedicaid reimbursements. The alternative – cuts to Medicaid andcuts to local medical services – could not only damage KDMC andother hospitals, but entire communities.

“We really need our legislators to stand up and take care of thehealth care providers that are out there,” he said. “Health care issuch an economic driver for communities across the state. When yougo monkeying with that, you’re really gonna put your communities atrisk.”

Lawrence County Hospital Administrator Semmes Ross said hishospital and its parent facility – Southwest Mississippi RegionalMedical Center in McComb – are joined hand-in-hand in support of SB2013 with the hospitals in Lincoln and Franklin counties.

“We’re gonna have to have it,” Ross said of the bill. “Gov. Barboursaid he’s going to institute the cuts, and we can’t afford to havethe cuts in there.”

Ross said the proposed cuts to the program would cost LCH around$300,000 per year that would have to be made up “somehow.” He saidLCH would be forced to reduce personnel and services if SB 2013 isnot implemented.

If the bill is passed into law, however, Ross said LCH’s annualMedicaid reimbursements would total approximately $445,000. Thatwould be a much-needed end to the Medicaid debate, considering thehospital’s business is composed of more than 90 percentMedicaid/Medicare patients.

Legislative arguments over funding Medicaid have been many thisyear, often intense and always lengthy, as sin taxes and proposalsto tap into the state’s more than $300 million Rainy Day Fund havecome and gone repeatedly.

The Senate and House Republicans have been united in support of SB2013 for weeks, however, and many have been scrambling to promotethe bill before the July 1 deadline for the governor’s cutspasses.

“I don’t think the leadership in the House realizes the rippleeffect this is going to cause,” said District 92 Rep. Becky Currie,R-Brookhaven. “We’re not just talking about health care, we’retalking about a lot of jobs – people will be laid off because thehospitals will not be able to afford to pay them. In SouthwestMississippi, we don’t get much economic development and thesehospitals are our major employers.”

Currie – who opposed similar tax plans earlier in the session butsupports SB 2013 because of its higher Medicaid reimbursementtotals – plans to vote for the bill when the Legislature reconvenesnext week.

“All I can do is vote for this bill and encourage everyone to calltheir representatives and ask them to do the same,” she said. “Ifthis bill isn’t passed, the problems I foresee are huge.”

District 53 Rep. Bobby Moak, D-Bogue Chitto, has opposed all of thehospital assessment/tax plans that have been proposed during the2008 session, seeking instead to raise tobacco taxes or use moneyfrom the Rainy Day Fund to shore up Medicaid until next year.

Moak said he would make every attempt to find another solution forplugging Medicaid’s $90 million budget hole next week. He said hefavors a sister piece of legislation to accompany SB 2013 thatwould require any future cigarette tax increase to be put towardMedicaid funding. He also would like the House to have a chance tovote on using the Rainy Day Fund for immediate Medicaid needs andreturning to the debate table in 2009.

If the alternatives fail, Moak said he would vote for SB 2013 inthe end, despite his reservations about the plan.

“If the governor makes cuts to Medicaid, he has to cut pharmacies,kick people out of nursing homes and take away their glasses – I’mnot gonna let this guy do that,” Moak said. “If he forces me into acorner with his hospital tax, I’m gonna take the bullet. But first,I’m gonna try to find a way to stop it.”