Federal health care changes concern area hospitals

July 18--The CEO of Huntsville Hospital System doesn't believe the revised health care reform bill unveiled last week will be any better for Alabama hospitals and their patients than the previous proposal.

"Round 1 was going to have a negative impact on many hospitals in the state of Alabama," said David Spillers, CEO of a system that owns or is affiliated with 11 hospitals across north Alabama. "Round 2 doesn't look any better," particularly regarding cuts in Medicaid funds. "It still raises problems for many Alabamians."

As of late last week, "We haven't been able to quantify the real impact yet" from the latest Senate GOP health care bill, Spillers said. When the Congressional Budget Office's score of the revised bill is released, then "we'll know more about the impact."

The CBO analysis, originally expected to be released Monday, has been postponed. That change followed the announcement by Senate Majority Leader Mitch McConnell, R-Ky., that the Senate would delay considering the legislation as Sen. John McCain, R-Ariz., recovers from surgery. The original score had showed that 22 million more Americans would be without health insurance in 2026, compared to the current system.

Danne Howard, the Alabama Hospital Association's executive vice president and chief policy officer, warned last week against rushing into reforms that would "devastate" the health care system.

"The latest Senate version of the health reform bill makes a few tweaks, but none that help Alabama. Overall, it still leaves Alabama's hospitals and their patients in the same precarious position as the previous bill," Howard said in a statement. "There's no way to sustain the Medicaid cuts being proposed. If enacted, the changes will negatively impact access to care for all Alabamians."

Spillers said about 1 million Alabamians are covered by Medicaid, with about 800,000 of those being children, pregnant women and disabled elderly. About half of the babies delivered at Huntsville Hospital are covered by Medicaid, he said. The hospital has about 900 beds.

"If you're not covered by Medicaid and you have a low-paying job, it's hard to find affordable insurance in the state," Spillers said. But, "If people have no insurance and have a heart attack or a serious injury and end up at our hospital, they will get care just like someone who has insurance."

Dean Griffin, CEO of Lawrence Medical Center, was concerned about the original proposal, and is awaiting more information on the impact of the revised bill.

"We haven't quantified (the impact) at the individual hospital level, but we believe the bill as currently written will mean significant decreases in Medicaid (funding) and that would certainly hurt us," Griffin said last week, in discussing the first reform bill.

Lawrence Medical Center has a 98-bed hospital, and there are also five rural health clinics. One of those is a pediatric clinic in Moulton, which serves "a significant number of Medicaid patients," Griffin said.

If there are more uninsured patients, that generally means more uncompensated care, he said. "We just don't get paid or get paid very little."

Lawrence Medical Center is managed by the Huntsville Hospital System but is owned and operated locally.

"While there are numerous issues in the health care reform bill that need further deliberation, cutting Medicaid (and) Medicare and the increase in the number of the uninsured concern me greatly," Nat Richardson, president of Decatur Morgan Hospital, said in an email last week before the revised bill was released. That hospital is also part of the Huntsville Hospital System.

"We, as many communities, see a large Medicare and Medicaid patient population," he said. "More cuts to either of these programs would have a negative impact on our bottom line." If the number of uninsured patients increases in Alabama, "uncompensated care costs will rise and our hospital and economy will suffer," Richardson said.

"When hospitals are suffering, that affects jobs," said Griffin, who estimates Alabama hospitals employ 90,000 to 100,000 people. "We are certainly very concerned."

Provisions of the reform measure have "the potential to have a very negative affect on hospitals as care providers, economic drivers and employers in their communities," Griffin said.

Huntsville Hospital, Spillers said, is "blessed to be in a growing market, and that makes it easier for us to manage these types of cuts" than hospitals in communities that aren't growing.

"If these cuts are enacted, we will face some difficult decisions about the services we provide," Spillers said. "But I'm an optimist. I have enough confidence in our organization that we will figure out how to handle whatever happens."

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