Public Versus Private Florida Hospital Battle Continues Into the Funding Arena: The Miami Herald Reports that HCA, Baptist Hospitals Are Gaining State Funds, While Jackson Health System Loses

After a bruising battle during the 2011 Florida Legislative Session over whether to require the any sale or lease of a public hospital that is owned by a county, district or municipality to be approved by a majority vote of the registered voters or by a circuit court, the public versus private fight continues into the funding arena, as reported last week by The Miami Herald:




HCA, Baptist gain state funds while Jackson Health System loses
By John Dorschner
jdorschner@MiamiHerald.com

Posted on Fri, May. 20, 2011

In a major shift on how the state funds hospitals, the Florida Legislature has decided to spread more money among for-profit and nonprofit hospitals to compensate for their care of the poor and uninsured — and give less to the state’s public hospitals.

The money comes from the Lower Income Pool, a billion-dollar pot of state-federal dollars that has traditionally been allocated by the LIP Council, a group dominated by the state’s public hospitals. For-profit hospitals have long complained that they too have to treat the uninsured in their emergency rooms and should be reimbursed more for their care.

New calculations

The Legislature generally follows the LIP Council recommendations — but not this year. With Gov. Rick Scott and legislative leaders questioning the need for government-run hospitals, the Legislature applied new calculations to give more reimbursement money to nongovernment hospitals that provide some care for the poor.

The Legislature generally follows the LIP Council recommendations — but not this year. With Gov. Rick Scott and legislative leaders questioning the need for government-run hospitals, the Legislature applied new calculations to give more reimbursement money to nongovernment hospitals that provide some care for the poor.

The biggest loser: Jackson Health System, usually the largest recipient of LIP funds. It saw a $20 million drop — 8 percent — from the amount recommended by the LIP Council, according to an analysis by the Florida Hospital Association.

The biggest winners are the for-profit HCA hospitals, which gained $23.3 million — or 83 percent more than the LIP Council recommendation, according to the FHA. Baptist Health South Florida gained $12.8 million — 94 percent more than recommended by the council.

Alan Levine, a healthcare policy advisor to Scott and earlier to Gov. Jeb Bush, says the reallocation makes sense. “There are many hospitals … both not-for-profit and investor owned that provide significant amounts of care for the poor.”

Levine and Scott are strong proponents of “tax dollars following the patient,” rather than all healthcare tax money going to government hospitals.

Jackson executives had no comment but Martha Baker, president of SEIU local that includes Jackson healthcare professionals, called the legislative action “outrageous…. This disrespects both taxpayers and those who use Jackson’s lifesaving services. HCA and Baptist had record profits and yet our politicians are diverting taxpayer money away from our neediest citizens.”

Baptist Health spokeswoman Roymi Membiela said the system’s costs for the poor have continued climbing and it was “very appreciative” of the Legislature’s action. HCA did not respond to a request for comment.

Carlos Migoya, Jackson’s new chief executive, has said that he endorses the theory of healthcare tax dollars following patients, but he hopes that legislators delay full implementation of the move until Jackson is back on its feet financially. Jackson lost $337 million the last two years and is projected to lose about $80 million this fiscal year.

According to the FHA analysis, Jackson saw its LIP funding drop to $221.3 million in the Legislature, although the LIP Council had recommended $241.3 million. Between LIP and Medicaid reductions, Jackson expects to see a reduction of about $130 million in state funding next year.

Studies by Rand Corp., a think tank, have found that a hospital’s location may have more effect on the amount of uninsured care it ends up providing than its status as a for-profit or nonprofit hospital. One example: Plantation General, a for-profit HCA facility near Broward Boulevard and Highway 441, had uncompensated care costs amounting to 7.6 percent of its total billings, according to state data — more than twice the amount provided by Holy Cross, a nonprofit Catholic hospital in affluent northeastern Fort Lauderdale.

Under the new calculations this year, the Legislature approved $5 million in LIP funding for Plantation General — more than twice the $2.8 million recommended by the council. Homestead Hospital, which cares for many uninsured migrants as part of Baptist Health, received $7.5 million in LIP money, 58 percent more than the council recommendation. Baptist Hospital in Kendall was given $18.1 million in LIP funds, more than twice the council recommendation. The nonprofit Baptist system reported an audited surplus — the equivalent of profit for a for-profit company — of $272 million for fiscal 2010.

Reform act

Long a target of business lobbyists such as Associated Industries of Florida, the LIP Council is set to die in 2014 as part of the just-passed Medicaid Reform Act. It will be replaced by a formula to determine how much each hospital should receive in LIP funding.

Long a target of business lobbyists such as Associated Industries of Florida, the LIP Council is set to die in 2014 as part of the just-passed Medicaid Reform Act. It will be replaced by a formula to determine how much each hospital should receive in LIP funding.

“Nobody understands what would be the impact of the new formula,” said Anthony Carvalho, head of the Safety Net Hospital Alliance of Florida, which represents Jackson and other public/teaching hospitals. “I am very concerned about what has been put into the statutes.”



© 2011 Miami Herald Media Company. All Rights Reserved.
http://www.miamiherald.com

Read more:
http://www.miamiherald.com/2011/05/20/v-print/2226085/hca-baptist-gain-state-funds-while.html#ixzz1NKBzdob5

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