If you didn't believe me before about the failure to expand Medicaid, maybe you will now

Southwest Regional Medical Center in McComb let five of its doctors go this past week.  In an AP interview, its CEO, Norman Price, said what I've been saying all along:

"The Affordable Care Act will force the acute care delivery system to evolve to accommodate a new reimbursement reality. As a result of the Affordable Care Act, the non-expansion of Medicaid will have the effect of over-running the emergency departments with non-paying patients. The inevitable cuts and changes will not be popular nor easy to accomplish. However, all will be necessary in order to move this medical center forward into the new Affordable Care Act world." (Emphasis added.)

And remember those DSH payments I've mentioned before (here, here, here, here, here, here and here)?

"We know we're going to be cut $8 million by the federal government, and we also know we're going to be cut 2% by Medicaid. That's going to equate to about $8.5 million to $9 million," Price said. 

The $8 million refers to the amount of money the hospital receives per year for taking on a disproportionate share of patients who are on Medicare or Medicaid.

DSH stands for "disproportionate share hospital".  The DSH program was established to give financial help to hospitals that provide care for an inordinate number of indigent patients.  As you can imagine, Mississippi hospitals are pretty dependent upon payments from the DSH program.  Under the Affordable Care Act, which is the law of the land regardless of how you feel about it, DSH payments are being severely restricted.  Why? Because patients that were causing hospitals to get DSH payments in the past were supposed to be covered by Medicaid expansion.  A Medicaid expansion, mind you, funded almost entirely by the federal government, not the state.

So as our Governor and his cohorts in the Legislature keep whistlin' Dixie, our health care system is burning to the ground.  

File under "We told you so": Hancock County's only hospital on the brink

Dire news out of Hancock County today as the county's only hospital looks for $6.1M to shore up its budget.   From WLOX:

Hospital leaders says they need the bond to finish post-Katrina reconstruction work and to resolve operating issues that have come up due to patients who fail to pay for services. 

The CEO declined to go on camera, but in a news release stated they also need the money to make up for decreasing federal reimbursements from Medicaid and Medicare. 

"It was almost a sense of shock and urgency," said District 5 Supervisor Tony Wayne Ladner.

Hancock County residents are now facing at a possible tax increase to fund the hospital's shortfall.

So let me walk you through this:

1. First of all, Hancock Medical Center CEO Craig Cudworth did more than just refuse to go on camera for WLOX.  During the special session dealing with Medicaid expansion, Cudworth refused to lobby for Medicaid expansion.  
2. That same Medicaid expansion, paid for by taxpayers from places like New York and California, would have helped solve the budget problem Hancock Medical now faces.  But as we know, Medicaid expansion didn't happen.  
3. So now, the taxpayers of Hancock County are faced with a potential tax increase to make up the hole in the budget created by "decreasing federal reimbursements from Medicaid and Medicare."

Now, don't think this is a one-time problem, or that it won't affect your local hospital.  Bear in mind that the Medicaid and Medicare DSH payment cuts are going to increase in severity going forward.  Hancock Medical is just the canary in the coal mine.

Senator Cochran warned us of this, if you'll recall.