Wooster Hospital talks Affordable Care Act

WOOSTER -- The day before the United States Supreme Court announced its ruling in the latest lawsuit brought before it regarding the Affordable Care Act, leaders of Wooster Community Hospital discussed what they have seen since the implementation of the law.

"We've seen more patients on Medicaid than ever before," said Bill Sheron, CEO of the hospital at Wednesday's board meeting. "We've also seen more ER visits than ever before."

Sheron later added the hospital's bad debt figures have reached historic levels.

The reason, he explained, comes from more people visiting the hospital with some sort of health coverage. But those people still cannot afford their deductibles or co-pays through those plans, such as insurance plans through the marketplaces set up for individuals to buy insurance.

As reported during the hospital's meeting, bad debt accounts -- money written off to collections from unpaid patient bills -- has exceeded $3.46 million through the end of May. This equates to 3.89 percent of gross patient revenue at the hospital.

At the same period in time one year ago, the hospital wrote off $2.22 million, for 2.77 percent of gross patient revenue.

Additionally, Sheron said requirements by medical providers to update software has put pressure on physicians as "more hoops you have to jump through."

Those pricing pressures, Sheron said, do not appear to have hit medical equipment companies yet as many still want to charge the same amounts as in previous years.

He said it appears health insurance companies have been "doing very well," but noted low interest rates are driving large insurance companies to look at possible mergers or acquisitions of others. Sheron surmised this will lead to reduction in competition and he is "not sure that's good for the marketplace."

Security breaches also are a concern with more health data being stored electronically.

"It's some health reform," Sheron said, but he still opined health insurance and Medicare were not designed to cover everything. He said much like car or home insurance it should be reserved for "catastrophic events," and said if people paid sometimes, they would likewise use less insurance.

"The strategy is to keep costs down," Sheron said, while also being transparent and focusing on patient outcomes. "We think that's the way to survive ... there's a lot of headwinds still with (the ACA)."

He said the Level 2 nursery, transitional care unit, and retail pharmacy have been good decisions for the hospital.

"Unfortunately, I hear more negative outcomes than positive," Mayor Bob Breneman added.

Board member Yvonne Williams said she believes the law's goals were not clearly stated and therefore it is hard to measure the outcomes. She added there has been so much "unexpected fall-out" as the law has been unveiled.

"This hospital has fared well," Sheron said, adding they anticipated the health care climate as best as they could. He equated it to like trying to swing at a wiffle ball though, which constantly moves in the air.

Reporter Steve Huszai can be reached at 330-287-1645 or [email protected]. He is @GeneralSmithie on Twitter.