Hospitals propose plan to cover uninsured Mississippians

Jun. 26--In the last year, Mississippi hospitals absorbed more than $624 million in uncompensated care costs to uninsured residents.

In less than a decade, five hospitals across the state have closed.

Tim Moore, the CEO of the Mississippi Hospital Association, represents 96 healthcare providers throughout the state who propose a private-public partnership to cover the estimated 300,000 Mississippians stuck in the "gap," or those who make too much for Medicaid and not enough for monthly health insurance premiums.

But Moore made an important distinction for Mississippi's version of the program.

"This is not Obamacare. This has nothing to do with the (Affordable Care Act). It is an opportunity that hospitals have seen to provide as much coverage to Mississippians and make it possible for them to get the best quality healthcare that they possibly can," Moore told the Rotary Club of Meridian on Wednesday. "We don't want any expense to the state of Mississippi or the taxpayers."

Moore called it Medicaid reformation, emphasizing that the organization doesn't want to expand a "broken" system like Medicaid.

By expanding Medicaid, which Mississippi declined to do, states can get a 90 percent match from the federal government with a ten percent contribution.

Under the Mississippi Cares program, hospitals will contribute that ten percent by combining premiums from participants, which will generate $72 million for 300,000 people, with $78 million from hospitals, creating a combined savings approximately $546 million for hospitals providing uncompensated care.

"Think from a small business perspective what this could be worth. Small businesses employ people in a lower income bracket, they can have that support now and so they can have a healthy workforce," Moore said, adding that roughly 200,000 of the 300,000 people without insurance are employed but don't earn enough for insurance.

To create the Mississippi Cares program, the Mississippi Division of Medicaid would need to provide a 1115 waiver, which waives certain federal requirements and gives the division authority to approve "experimental, pilot or demonstration projects." Then the Mississippi legislature would have to amend the Mississippi code.

With Mississippi as one of 14 states who didn't expand Medicaid coverage to close this insurance gap, Moore said Mississippi lost out on federal funding.

"You're already paying for it. They're just going to different states," Moore said.

Moore said that some Republican gubernatorial candidates have supported the idea, including Bill Waller and Robert Foster. With the hospital association, Moore said the state is in a unique position for hospitals to collaborate.

"Mississippi is unique in the sense that our hospitals, for the most part, work together," Moore said. "This is beneficial for Mississippians, it works for us and we can change the way we deliver healthcare... We can tell state leadership, 'There's another, better model.' And that's why we're here."

Moore said both Anderson Regional Health System and Rush Health Systems, both part of the hospital association, were on board with the other 94 hospitals.

The Meridian Star offered both hospitals an opportunity to comment on the plan Thursday afternoon, but no response was available.

"If you look at the current model that we have, there are major challenges in the communication between payers and providers. There are disagreements on the payment model and how it should be done (and) frequent delays in payment," Moore said. "There are delays in getting physicians credentialed in a timely manner, which means they can't see your population."

Unlike the current model, the proposed model would be designed by providers and not private insurance companies, keeping money within the state instead of going to outside insurance companies.

Mississippi Cares highlights the economic benefits that come with the program in addition to reducing uncompensated care, such as increased retail spending, higher personal incomes and a more productive workforce.

"The most important thing that Mississippians can do is understand the program, talk about with other folks and make sure they know what it is and, most importantly, talk to their representatives and senators and make them aware of how important it is," Moore said. "If you cut uncompensated care in the state of Mississippi by one half, it is a huge benefit."

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