opening thoughts
A
word from PCRMC CEO, John Denbo
By Amy Wilson Health care finance may not be the easiest concept to understand, but it doesn’t take much experience to realize that if almost 60 percent of a hospital’s revenue comes from the federal government, any reductions to that revenue stream will likely have an impact. When CEO John Denbo was asked how he would deliver a “state of the union address” regarding Phelps County Regional Medical Center, he noted while the hospital is in a strong financial position, a decrease in payments from the federal government is pushing the hospital into uncharted territory. “We are really trying hard to absorb those cuts by becoming more efficient and effective while maintaining and improving the quality and safety of the care we provide, but the cuts are coming so fast,” he noted. “There doesn’t seem to be an end point to the cuts.”
Why now? The funding issue has hit a boiling point as a result of efforts to implement the Patient Protection and Affordable Care Act, also known as “Obamacare.” The focus is now on finding a way to reduce the number of uninsured Americans. The federal government appropriated funds at that time to be used for the purpose of setting up insurance exchanges where people who can’t currently buy health insurance would be able to purchase it. “It was recognized that there would still be a gray area of people who might try to buy through those exchanges, but wouldn’t be able to afford it,” Denbo said. To address that issue, the law proposed an expansion of the Medicaid program, and pledged to fund 100 percent of the costs for three years beginning in 2014 and 90 percent through 2020, with the states picking up the remaining amount. At the same time, the Affordable Care Act also included immediate reductions in Medicare payments to hospitals which began in 2010 and will continue through 2020. The monies saved by these reductions were to be recycled and sent to the states to assist them in setting up
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Foundation in Focus | Summer 2013
Foundation IN FOCUS
MISSION STATEMENT
To serve as the philanthropic organization that facilitates charitable donations to support and assist the mission of PCRMC in providing for the health care needs of the communities it serves.
VISION STATEMENT
Be the best hospital foundation dedicated to sustaining and advancing PCRMC in providing world-class healthcare for the continued benefit of our service community. Phelps Regional Health Care Foundation
2013 BOARD OF DIRECTORS
Ted Day, R.Ph., President Candace Connell, Vice-President Deborah Schuetz, Treasurer John Denbo, Ph.D., Ex-Officio Virginia Lomax, Ex-Officio Cindy Beger Mary Graham, MD Ollie Jackson Patricia Leaders Dwight Look, MD Kathy Nickason Mark Riefer
Phelps Regional Health Care Foundation
STAFF
Lorrie Hartley, CFRE Executive Director Donia Camarena Major & Planned Giving Specialist Lori Moss Annual Giving Coordinator Ashley Brooks Fundraising Coordinator Robyn Owens Administrative Assistant
PRODUCTION TEAM
Lori Moss Editor Amy Wilson Staff Writer, Copy Editor Ashley Brooks Graphic Designer
A word from Denbo continued from page 1 insurance exchanges and expanding Medicaid at the state level. “We have already experienced a 10 percent decrease in Medicare payments since ‘Obamacare’ passed,” Denbo said. However, he explained that with the expansion of the Medicaid program, hospitals would at least receive some of the funding that had already been promised. However, the Missouri legislature was unable to agree on the expansion issue during the 2012 legislative session, meaning that the state will not expand Medicaid. As a result, the state will not receive the federal funds. There is also concern about expanding a program that already has problems. “Maybe it is not the best, but it is not the worst,” Denbo said. “My frustration is all of that may very well be true, but hospitals are desperately in need of that money. Not getting the money is going to hurt the quality of care, and some hospitals will have to cut services and staff. Patient care will suffer and some hospitals may even close.”
What happens next? Hospital officials will continue to meet with state legislators to provide them with information about the economic impact. “We want the state legislature to examine this issue, no matter how they feel about ‘Obamacare.’ Whether you are Democrat or Republican, we urge them to work together to get the healthcare providers the resources they need.” Because PCRMC is a “safety net” provider, the hospital does not turn anyone away. Not only does the hospital provide the only in-patient psychiatric unit within a 100-mile radius, but the hospital also provides ambulance services to the community without tax support. Even though PCRMC is a county hospital and could receive a tax levy, it has not received any tax monies for over 30 years. “Over the last four years, our uncompensated care has gone from $10 million to $33 million,” Denbo said. “People are coming in needing services and we are providing them. Those without health insurance would at least be able to get on Medicaid if the state would accept the federal money. The state doesn’t
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Foundation in Focus | Summer 2013
have to raise any taxes. This is money we have already forfeited to the federal government.” If the goal of the Affordable Care Act is to provide access to health care, the state’s decision to not expand Medicaid complicates that process. He explained that instead of a basic office visit where you are told that your sniffles are a result of a cold, a trip to the emergency room is likely to get you a chem screen and a chest x-ray because the emergency room doctors can’t be wrong or they get sued. “Is that optimal care? That is over care with no preventative focus. It’s problem specific,” he said. “You will get your complaint explored and we will have over expended resources. Appropriate care is what people with insurance get if they have a medical home. Turning people away is not the answer. How can we not be there to meet that need?” Denbo encourages area residents to be aware of the healthcare funding issues and participate in the discussion and make their opinions known to our legislators. For current and potential donors, there is a secondary message. “One of the obvious conclusions is that money gifted to us is more important than ever before,” Denbo said. “There has never been a greater need. I could see where people would question the need with an $8 million to $10 million bottom line, but that is no longer the case. More than ever before, we are going to need to depend on the generosity of our donors to provide us funding so that we can continue to provide citizens in our service area with the high quality services which they need and deserve.”