|MHP Critical Access|
|Friday, 02 November 2012 08:46|
In covering other stories at Mahaska Health Partnership, we've often been told that MHP is designated as a critical access hospital. We wanted to find out exactly what that means. But as we learned more about the financial benefits of being a critical access hospital, we got into a broader discussion on MHP's profitability. I met up with Chief Medical Officer Dr. Matt Whitis in the emergency room. He says MHP gets a little extra in Medicare reimbursements since it's classified as a critical access hospital.
"Smaller towns like this that are located so many miles away from other towns and have a hospital limited in size, less than 25 beds, they realize it's sometimes hard to be profitable in these days because of our volumes."
Whitis says the hospital's critical access classification means it gets reimbursed the cost of care for patients on Medicare, plus an extra two or three percent. And that helps offset some of the discounted or free care the hospital gives to people who need it. He says it's a good start, but since MHP serves fewer people than a large hospital in a metropolitan area would, he'd like to see the way hospitals get reimbursed change.
"Irregardless of who gets elected and what they do with Obamacare, something's going to have to happen with our healthcare system. And they're going to have to make the healthcare community, the people who provide healthcare, become more responsible for community wellness, for keeping people out of the hospital. We have to change our mentality from getting paid for how much we do to getting paid for how well we do it."
Whitis says there aren't any laws that reward healthcare providers for doing their jobs well and keeping patients OUT of the hospital. He says the better job hospitals do at keeping people healthy, the less money they make.
"So if we do a good job, and we do this anyway, but if we were to immunize everybody in the community against influenza, and we see less volume, we actually see our revenue go down. All these things that we do right now, there's no compensation for it, in fact, there's a disincentive to do that kind of stuff in the current financial model. And most health systems are driven by more than just finance, but it would be nice to have some rewards for keeping people healthy."
And Whitis says a key to keeping people healthy is making sure they can afford care---too many people avoid the doctor because they can't pay for a visit. The current administration says the goal of the new federal healthcare reform law is to combat that. But some people are concerned that some of the fees associated with healthcare reform will have a negative impact on the economy. The federal healthcare reform law includes an expansion of Medicaid to help cover people who would otherwise not be able to afford insurance. And the Supreme Court says the federal government can't require states to participate in the expansion. Some states have already decided whether to accept or reject the expansion. Other states, including Iowa, haven't decided yet. But Whitis says it's important that Iowa participates. He says a Harvard study shows that states who choose to expand Medicaid see a difference-- for every 176 people covered, 1 life is saved.
"So there's a lot of people out there that are between Medicare age, 65, and childhood age, where we do a pretty good job of covering them, these are the 20 year olds to 65 year olds that are dying. And it's just sort of a hidden epidemic out there, that if you don't have access to healthcare, your odds of dying from a treatable health illness, it's surprisingly high."
The Medicaid expansion is set to start in 2014, but there's no set deadline for undecided states like Iowa to make up their minds.