Right now local healthcare facilities are dealing with the pain of the recession, and the growing number of uninsured residents needing free care. But another ailment is starting to plague the healthcare industry. A local expert tells us how Medicare and Medicaid are weighing down local hospitals.
Doctor Bill Gorski says more than 20 percent of the patients Swedish American sees a year are on Medicaid. And this number is expected to grow as the population ages. But the thing that’s not keeping up with demand and posing financial pain for the hospitals is the state reimbursement for patient care. The state is six months and several million dollars behind in paying Sweds for patient treatment. The biggest shot in the arm for healthcare facilities is the ratio of funding based on the care.
“The funding is not appropriate to the level of care and the timeliness of care that we experience these days. So if something costs you a dollar to provide it, Illinois state Medicaid generally funds between 60 and 80 cents of that dollar, so you can see that's a loss position. We all know that exceptionally high care costs less... it is not more expensive. It is actually less expensive.”
Medicare and Medicaid make up the majority of the reimbursement for hospitals. Gorski says the payment is fixed based upon the patient’s condition. He says the reimbursement does not factor in the costs associated with the time the patient was in the hospital and the level of care provided.