Kentucky State Auditor of Public Accounts Adam Edelen hosted a town hall meeting in Leitchfield last Friday, Aug. 15 to discuss and assess the fiscal health of local, rural hospitals.
More than 80 people crammed into Leitchfield’s Elizabethtown Community and Technical College Campus to hear from Edelen and express their concerns regarding the current state of rural healthcare.
“The largest taxpaying investment in Kentucky is health,” Edelen said. “There are more people on Medicaid in Kentucky than kids in public school - that’s not sustainable.”
Edelen said, with that in mind, he and his staff decided to host 10 town hall meetings across the state to learn about the struggles facing rural healthcare providers first-hand and figure out how to make sure these providers stay open.
“If we don’t watch it, we’re going to lose a network of rural hospitals in Kentucky,” Edelen said.
A number of healthcare officials expressed concern that, with recent changes to the way healthcare operates in the wake of the passing of the Affordable Care Act, they will not be able to focus as much on what’s most important - their patients.
Following Edelen, Elizabeth Cobb, Vice-President of the Kentucky Hospital Association, spoke.
“The hospital is responsible for the health of the community,” Cobb said. “It’s also a major player in the economic health of the community.
“Hospitals have always been stable employers in their communities. The hospital is often the healthcare hub for the community.”
Cobb said, if rural hospitals close, “we lose resources for recruiting new healthcare providers and assistance to other providers.”
Twin Lakes Regional Medical Center CEO Wayne Meriwether then spoke on the three major issues he felt are currently affecting rural hospitals: the declining patient volume, manage care organizations, and the Affordable Care Act.
Meriwether said the declining patient volume is likely a result of higher deductibles for health insurance plans. As a result of this, some hospitals have had lay-offs and taken other budget-cutting measures.
In regards to the manage care organizations, which manage healthcare services across the state, fees and the credentialing process for new physicians has drastically affected what care can be provided to patients, according to Meriwether.
Previously, certifying physicians took a period of only a few weeks; now, it can take several months.
In addition, the Affordable Care Act, which has been, thus far, “a positive” for TLRMC, will, in time, prove detrimental.
Before the Affordable Care Act, 4,400 people were uninsured, now 3,000 of those people have coverage. Additionally, TLRMC has seen a five percent reduction in write-offs - which leads to the hospital receiving payment for services it originally offered for free.
However, Meriwether said, someone will, eventually, have to pay for the insured. Over the next eight years, rural hospitals expect to see a significant reduction in Medicaid and Medicare reimbursements.
“Hospitals will close - ours may be one of them,” Meriwether said.
If TLRMC were to close, Meriwether said, 300 people would lose their jobs, resulting in a loss of $30 million in salaries, and many patients would have to travel much farther distances to receive healthcare.
Angela Portman, CEO of Breckinridge Memorial Hospital (BMH), echoed Meriwether’s sentiment.
“There are a lot of lives saved in our emergency room,” said Portman, whose hospital is located close to the Rough River area. “If the hospital weren’t there, it would impact a lot of families.”
Another issue BMH has dealt with has been that of the influx of new patients, who now have Medicaid, but may have let health conditions go unchecked due to the cost.
Portman said, the biggest issue with the recent changes, however, has been the poor communication regarding how hospitals must now operate.
Many items are now regulated that weren’t before, and hospitals may not find out about things they need approval for until they receive a denial, she said.
“You need people to keep you compliant,” Portman said. “Struggles for rural health are many.”
The results of Edelen’s town hall meetings will be compiled into a report, tentatively scheduled to be released this fall.