Nebraska hospitals enter the new world of federal health care hopeful, but cautious.
The numbers tell a stark story about hospital economics. The Nebraska Hospital Association reports its 89 hospitals treat 11,000 patients a day. Those hospitals have annual net patient revenue of $4.9 billion. Twenty percent of the care given is uncompensated.
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Bruce Rieker, vice president for advocacy for the association, says $370 million is the cost not covered by Medicare reimbursement, absorbed by 25 of Nebraska’s largest hospitals. Medicaid fails to cover $138 million of the cost of its patients. The hospitals provide $163 million in charity care annually.
Though the federal healthcare law will expand coverage, it also will pinch reimbursement to providers, primarily hospitals.
Rieker tells lawmakers a deal struck in Washington will reduce Medicare reimbursements to hospitals by $155 billion.
“As we shift cost, you’re seeing that we’re putting more and more pressure on those that are buying their insurance and paying their bills to cover the costs that we’re incurring to provide the care,” according to Rieker
Another problem has arisen for hospitals: bad debt.
Rieker says the amount of bad debt hospitals have had to write off has increased by $35 million since 2008 as those with private insurance either are unable or unwilling to pay their deductibles.
The federal health care law will expand the Medicaid rolls even if the state chooses not to extend Medicaid to those making up to 138% of the federal poverty level. Rieker estimates the new law will add 20,000 Nebraskans to the Medicaid rolls. If the state chooses to expand eligibility, the number added will increase by 107,000, according to Rieker.