Hos­pi­tal strug­gling with unin­sured, un­der­in­sured

The Covington News - - FRONT PAGE - ROB DEWIG rdewig@cov­news.com

A month ago, New­ton Med­i­cal Cen­ter officials asked the county to up its mill­age from 1.2 to 1.5 to help care for ever-in­creas­ing num­bers of un­der- and unin­sured pa­tients. The county dis­missed it, cit­ing a tight bud­get and a tighter time­frame. The $600,000 that the ex­tra mill­age would have pro­vided didn’t come through.

Not that it would have made much of a dif­fer­ence. The hos­pi­tal is los­ing mil­lions each year, writ­ing off an in­cred­i­ble 71 cents of ev­ery dol­lar billed. In larger terms, the hos­pi­tal’s rev­enue in 2014 is pro­jected to be $75,157,000. The ex­penses? $80,562,000. That’s a loss of $4,405,000.

“It’s in­sane,” CEO and ad­min­is­tra­tor James Wead­ick said Tues­day. “It re­quires us to keep our op­er­at­ing ex­penses to less than 29 cents on the dol­lar of op­er­at­ing charges.”

The main prob­lem is the age-old mind­set that sees the emer­gency room as a pri­mary-care doc­tor. In­di­gent care to New­ton County res­i­dents will ac­count for $20,151,00 of the hos­pi­tal’s ex­penses, for which the county via its 1.2 mills will pro­vide $2,283,000 in re­im­burse­ments.

“In­di­gent” pa­tients in­clude the un­em­ployed, peo­ple with no in­sur­ance, and, for ex­am­ple, fam­i­lies of four or five who make less than $25,000, and those who re­ceive cov­er­age from the Health In­sur­ance Mar- ket­place (Oba­macare) with its mas­sive de­ductibles, Wead­ick said.

“Those peo­ple don’t have health in­sur­ance, for all prac­ti­cal pur­poses,” he said. But they still need care, and the hos­pi­tal is here to give it to them.

One of the hos­pi­tal’s seem­ing up­sides – it’s right here – is also a neg­a­tive when it comes to real-world dol­lars. East of Cov­ing­ton, there are es­sen­tially no hos­pi­tals un­til Au­gusta. That means sick peo­ple come here.

The hos­pi­tal has taken steps to try to cut back on the bad debt ex­pense of 45,000 peo­ple who visit the hos­pi­tal’s ER each year who are not emer­gent and not in­sured (that num­ber was just 11,000 in 1993). Every­one who comes to the ER is checked to see if they are med­i­cally sta­ble and they don’t need emer­gency care im­me­di­ately. Those who need emer­gency care get it, and right away.

Those who don’t – Wead­ick cited stom­ach aches as a com­mon ill­ness – are screened as usual, but then asked to pay a $150 down-pay­ment, in­sur­ance co-pay or are ad­vised to seek a pri­mary-care doc­tor’s ser­vices. That prac­tice has been in place for two years.

“It has been help­ful,” Wead­ick said. “It has re­duced busi­ness vol­ume by about 10 per­cent, and col­lec­tions per pa­tient have gone up.”

To of­fer more help, the hos­pi­tal launched the New­ton Med­i­cal Fam­ily Prac­tice in the K-Mart shop­ping cen­ter, where Dr. Donna Groover of­fers pri­mary and fol­low-up care. It’s another op­tion other than the ER.

The in­di­gent prob­lem con­tin­ues get­ting worse, swamp­ing the hos­pi­tal’s ef­forts to date. Wead­ick said the num­ber of un­em­ployed and un­der­in­sured con­tin­ues to grow, and a pro­vi­sion of CMS called the 2-mid­night rule isn’t help­ing. It takes into ac­count only the time a pa­tient is in the hos­pi­tal when it comes to re­im­burse­ments, not the care re­ceived. So what to do? Wead­ick smiled: “Give me $20 mil­lion. I know that’s un­re­al­is­tic.”

Se­ri­ously, he would like to see the county up its mill­age rate for the hos­pi­tal. It’s been 1.2 since 2004, and that worked to keep the hos­pi­tal in the black un­til 2008, when the re­ces­sion knocked the wheels off. Since then, the value of a mill has steadily de­clined while the cost of ser­vice has risen ex­po­nen­tially.

Wead­ick said hos­pi­tal officials have sev­eral op­tions to de­crease its losses, but de­clined to dis­cuss specifics un­til they’re a lit­tle fur­ther along.

“There’s al­ways go­ing to be a hos­pi­tal here in New­ton County to take care of the peo­ple,” he said. “Not just a hos­pi­tal, but a fine hos­pi­tal that pro­vides qual­ity care.”

Newspapers in English

Newspapers from USA

© PressReader. All rights reserved.