During the Nolan County Hospital District Board of Directors' meeting on Monday night, November 26 at Rolling Plains Memorial Hospital (RPMH), discussion was held on how upcoming political issues--namely the Affordable Care Act (also called "Obamacare") and the looming fiscal cliff, would possibly impact the local hospital.
Hospital administrator Donna Boatright acknowledged that there are several unknowns in the next year for both of the issues at hand. But the most immediate issues relate to the fiscal cliff and its impending cuts.
"Many of the problems facing us pre-date the ACA [Affordable Care Act]," Boatright explained in an email statement. And should the fiscal cliff drop off after the January 1, 2013 deadline, cuts would result which would affect reimbursements and the financial status of the hospital.
"One provision, known as the Medicare Low Volume Adjustment, expired in September," said Boatright, "and unless renewed by Congress soon, it will cost the hospital approximately $500,000 a year."
She also cited another provision known as Outpatient Hold harmless, which has a December 2012 expiration date. If it is not renewed, the hospital would feel an annual impact of $400,000.
"If the budget sequestration occurs on January 1, the hospital will lose another $130,000 a year," Boatright conceded. "These are serious numbers to a hospital our size and are certainly a concern to our tax payers."
On the other hand, the hospital administrator stated at the meeting that while everyone will be affected by the ACA, there are still some unknowns to the health care reform. However, the hospital is still responsible to provide a medical screening exam to patients presenting to the ED.
"Those that choose to pay the penalty for not having health insurance will still be able to be seen in our ED and we are required by the EMTALA [Emergency Medical Treatment and Active Labor Act] legislation to provide a medical screening exam and treatment for emergency medical conditions," said Boatright.
"The patient may not have means to pay, but we are required to provide for them to this extent."
But, because the hospital has no say on a person's decision to provide health care the penalty ends up being placed on the provider, which in this case, is the hospital. Boatright said that the hospital strives to provide indigent and charity care to all within the county, but at the same time they are also giving a large amount of "additional uncompensated care."
Throughout the entire process, Boatright mentioned that Rolling Plains Memorial Hospital--a rural hospital--will be affected differently than larger establishments. However, as the deadline draws closer and politics continue to play a large role, the main concern is to reduce the deficit, leaving no one to vouch for rural hospitals.
"Sweetwater residents need to contact their Congressman and ask that no Medicare cuts to the Sweetwater hospital be included in budget cuts," urged Boatright. "The more our community knows and feels compelled to call our legislators, state and federal, the more chance we have of not having rurals getting lost in the chaos."