Missouri finds itself in exclusive company: It is one of five states where 40% or more of its rural hospitals are deemed vulnerable, according to an analysis by the Charits Center for Rural Health.
Add the specter of a spreading coronavirus pandemic, and hospitals like Tobler’s find themselves on the brink of financial jeopardy.
“I’m watching people who are the most resilient people in the world beginning to crumble,” Tobler said of his staff as they grapple with what’s ahead.
Thin hospital finances at rural hospitals are taking a hit, even if the pandemic hasn’t reached most outstate counties in Missouri, because regular or elective medical procedures are being canceled in anticipation of coronavirus’ arrival.
“If you talk dollars and cents, the impact of reducing elective surgeries is a huge blow to many of our facilities,” said Patrick Geschwind, interim chief executive of Pemiscot Memorial Health Systems in the Missouri Bootheel. “That’s the most lucrative part of our business, a procedure done in our hospital versus a clinic.”
If a wave of coronavirus cases hits Pemiscot County in the coming weeks after revenue streams have been cut, its financial candle burns at both ends.
A proposal by MO Healthnet, which runs Missouri’s Medicaid program, is touted as a measure to realize budget savings and simplify notoriously byzantine algorithms used to calculate reimbursements for outpatient procedures. They forecast $60 million in budget savings from the idea.
Some hospitals and lawmakers fear the changes could cut funding when hospitals can least afford it.
An analysis by the Missouri Hospital Association claims an outpatient reimbursement proposal by the MO HealthNet Department, which runs Missouri’s Medicaid program, could lower outpatient payments to Missouri hospitals by more than $100 million next fiscal year.
“It doesn’t make any sense when we are already closing hospitals in Missouri, we never expanded Medicaid, so we still have large groups of people across our state that are not having access to health care,” said state Rep. Deb Lavender, D-Kirkwood. “It just doesn’t make sense for me that we are removing that much money from hospitals.”
Todd Richardson, director of MO HealthNet, testified to lawmakers before they adjourned last week that Missouri needed to update and simplify an outdated Medicaid reimbursement system.
“We have some of the most outdated payment methodologies in the country,” Richardson said. “This is not by any stretch the only thing we think needs to happen in healthcare, but we do think it is a big step in rationalizing and creating a better baseline for how we’re paying for a pretty big bucket of services.” (cont)
