Health providers eye changes
By KALEY CONNER
A proposed 10-percent drop in state Medicaid reimbursement rates has some local health care providers facing difficult changes.
The declined reimbursement was announced by Gov. Mark Parkinson late last month as part of his proposal to trim state spending by an additional $258.9 million.
"We're looking at how to adapt and adjust so we can keep our budget balanced and continue to operate and serve folks," said Walt Hill, executive director of High Plains Mental Health Center. "What we're able to do is going to have to change."
For High Plains Mental Health Center, the latest news follows years of significant reductions in state general fund dollars.
Since 2007, the organization's state funding level has dropped from about $2.1 million to about $970,000. It's expected the reduced Medicaid rates will take an additional $380,000, Hill said.
The organization, which provides community mental health services in 20 counties, has eliminated about 25 staff positions and considerably reduced its scope of services.
As a community health care provider, High Plains historically has received state funding to subsidize universal care -- meaning services were available to all, regardless of the ability to pay.
This health care reform funding was intended to reduce institutionalization and help keep patients out of state mental health hospitals, Hill said.
But with less revenue, fewer staff and more patients unable to pay for treatment, the scope of community services could change. It's possible consumers who are unable to pay and not facing emergency circumstances could have to wait longer for services, Hill said.
High Plains will continue to provide emergency care, and some costs are footed by county governments, which contribute a total of $600,000.
"That's part of what we're aiming to do is to remain viable to be that community safety net," Hill said. "But that state safety net is going to get stretched, and we are going to have to ask people to be patient and understand we just can't be all the things we previously were to all the people before."
Hill also noted he understands the state's position and remains hopeful the financial situation soon will turn around.
"I think the economy will come back, and hopefully state funding will come back," he said. "And our counties have just been excellent working with us."
The cut in Medicaid funding also could pose new challenges for area nursing homes. David Karlin, chief executive officer of St. John's, said about 50 percent of nursing home residents rely on Medicaid to pay for services.
While it remains unclear when the cuts could take effect, Karlin said he's heard the change could happen as early as next month.
"We don't have the specific formulas that will be used, and we haven't been informed of what Medicaid rates for patient care will actually be," Karlin said. "But it will be a tough road to hoe."
Already, administrators are looking at the organization's budget, trying to identify ways to cut expenses and boost revenue, which could mean a rate increase for private pay residents.
But as a non-profit organization, there isn't much room for adjustments, Karlin said.
"I see both sides of it. As a taxpayer, I understand you have to have a balanced budget," Karlin said. "As a health care provider, I know the cost of health care, and Medicaid is already short of meeting those costs."
At Hays Medical Center, administrators said the allotment has caused concern for some practices, including obstetrics and pediatrics, which see more Medicaid patients than other hospital caregivers.
Overall, the reductions aren't expected to have a significant impact on the hospital, said Chief Executive Officer Dr. John Jeter, noting it could cause greater concern for rural private practices and inner city hospitals.
"We're going to continue to provide services to those people. That's not going to change," Jeter said. "But there are going to be physicians around the state who are going to quit taking Medicaid."