……looking to eliminate up to 300 jobs, or about 9 percent of its workforce, in an effort to stabilize finances.
…..Cambridge Hospital, Somerville Hospital, and Whidden Hospital in Everett, says it is being hit hard by the state’s new healthcare reform law, which has left it responsible for providing free care for those without insurance while reducing the hospitals’ compensation for such services.
Before healthcare reform took effect last year, Keefe said, Cambridge Health Alliance was reimbursed by the state for the full cost of providing services to the uninsured. Under the new system, “we only get 60 to 70 percent,” he said. The reduction is particularly significant for the alliance because its hospitals serve a high percentage of uninsured patients. Despite the state’s efforts to enroll all low-income residents in free or subsidized insurance programs, many still do not have coverage.
Keefe said the hospital was especially bruised in its second fiscal quarter, which ended Dec. 31, when the new payment system for uninsured patients took effect. Government payments for free care to the uninsured fell by nearly $14 million compared with the previous quarter, he said.
At the same time, the number of patients admitted to the alliance’s hospitals dropped by about 3 percent, while patients kept overnight for observation – a category for which insurance companies do not pay as well – grew by 48 percent. Additionally, the number of walk-in patients, which do not generate as much revenue as inpatients, also grew substantially in the six months that ended Dec. 31, Keefe said.It is the largest provider of mental health and addiction treatment services in the state. Of 348 beds in use, 45 percent are devoted to mental health and addiction treatment, an unusually high proportion.
And this portion will touch any of you that are even remotely aware of reimbursments via the government:
Keefe said he has met several times with Dr. JudyAnn Bigby, state secretary of health and human services, to discuss the alliance’s finances. Bigby, in an interview, said Cambridge Health Alliance posted a surplus of $1.6 million in fiscal 2007 and is receiving “substantially” more public funding this year than last year.
more stories like thisShe acknowledged that the healthcare system is burdened because mental health services don’t pay as well as complex medical procedures like heart surgery and cancer treatment. But she also said the state had compensated the alliance for payments that were delayed by the federal government.
“The Commonwealth will continue to support Cambridge Health Alliance with public funding as much as we can,” Bigby said.
Keefe said the alliance is indeed receiving more money from the government this year, but that it is because of increased reimbursement for treating low-income patients, not additional funds to help the system stay afloat.
“It’s accurate for her to say that payments have gone up, but you have to deduct the expenses for providing medical services,” he said.
Can you see where the system is headed?
To stem losses, the health system has put in place a hiring freeze and eliminated discretionary spending, such as for travel and conferences. It is seeking to eliminate the use of contract nurses and other outside care providers, which cost more than using staff.
The system is also trying to keep more patients under its care for longer periods. It wants doctors to limit referrals to specialists or other physicians outside the alliance – something hospitals refers to as “leakage.”
“All staff needs to continue to focus on keeping patients within our system, as appropriate, and to continue to focus on improving our inpatient volume in particular by increasing admissions on each campus each day,” Keefe wrote in a Jan. 16 memo to staff. “We must also refer our patients for necessary services within our ambulatory care system whenever possible.”
Keefe said the hospital is also exploring ways to combine services among its three hospitals to minimize duplication. Cambridge Hospital and Somerville Hospital are ripe for consolidation of specific services, he said, because they are close to each other.
This is just the beginning..This is an example of government mandated insurance.
Hospitals closing because of non paying patients is nothing new to the Southwest. An editorial/article in the Arizona Republic today was lamenting the fact that a local hospital spent over $450,000 treating an illegal alien injured in a motorcycle accident and then (What is this world coming to?) had ICE deport her without using up a few hundred thousand more for rehabilitation. Yes it’s infortunate that a 22 yr old is confined to a wheel chair for the rest of her life, but why is it the responsibility of the hospital or US Taxpayer to provide her with free rehabilitation when she was violating the law by being in this country to begin with. How many poor children could’ve received a rubella vaccine for that $450,000+? How many mammograms could that have funded?
As long as people think that they can get healthcare for “FREE” instead of realizing that their friends, relatives and neighbors are paying for it, this kind of abuse will continue. I had a senior citizen complain to me today about losing 6 doctors to other cities over the last few years. She wondered why all of them were leaving an area that caters to the wealthy senior citizen, so I told her. I informed her about Medicare’s recent 10% reduction in payments to doctors and the additional 30% decreases that are planned over the next few years. Hearing how the doctors were being squeezed out of business by Medicare, she disgustedly responded “and we keep electing these guys..”