Hospitals Focus on Vulnerable Populations, Services for 2008-2009 Budget
Hospitals care for some of Ohio’s most vulnerable residents—Ohioans living in rural areas with limited access to general and obstetrical health care services as well the most-critically injured patients who come through hospital doors. State budget decisions are critical for the hospital community as it strives to meet the needs of these populations. OHA is already in discussions with the governor and legislators on the upcoming budget, proposing changes that will help ensure the protection of the most at-risk services in Ohio’s hospitals.

OHA Proposal #1: Support for Rural OB Services
A major challenge in providing health care services to the rural areas of Ohio is connecting pregnant women with the appropriate prenatal and postpartum health care. To ensure that pregnant women in rural areas of Ohio have access to obstetrical (OB) care, OHA supports the creation of a special state fund to make supplemental payments to rural hospitals that provide OB services. These hospitals currently incur significant losses to provide OB services and some of these facilities are on the verge of closing their units, leaving new and expecting mothers without needed services. Six million in state dollars each year of the biennium will help protect OB care for pregnant women and new moms in Ohio’s rural communities.

OHA Proposal #2: Preservation of Trauma Centers
A gunshot victim, a driver rushed from the scene of a car accident or even a heart attack patient comes to a hospital designated as a trauma center for emergency medical treatment. The 40 Ohio hospitals verified by the American College of Surgeons as level I, II or III trauma centers treat the state most critically-injured—providing services that illustrate the vital importance of hospitals but nearly always operate at a financial loss. The diverse mix of patients, many of whom are uninsured, and the expense of the treatment relative to payment received often leaves hospitals operating at a loss in trauma care. Hospitals are bound by both their fundamental missions and the Emergency Medical Treatment and Active Labor Act (EMTALA) to provide emergency, life-saving treatment without regard for a patient’s ability to pay for the services. To help preserve the state’s verified trauma centers through supplemental reimbursement, OHA requests the creation of a state fund at a cost of $4 million in state dollars for each year of the biennium.

OHA Proposal #3: Reimbursement for Critical Access Hospitals
In many rural areas of Ohio, the services of a single hospital support the health care needs of the entire community. These hospitals care for their patients first and discuss ability to pay later, which can push facilities dangerously close to a negative bottom line or even closure. To protect these vital services, Ohio classified 34 small and rural hospitals as “critical access hospitals,” which allows them to receive federal reimbursement for care to Medicare patients based on reasonable cost verses the formulas used to calculate payments for other hospitals. OHA asks that the Medicaid program also reimburse critical access hospitals on a reasonable cost basis to allow these vital facilities to continue serving their communities—a cost of approximately $8 million in state dollars each year of the biennium. Many of Ohio’s rural counties have a larger percentage of residents who rely on the Medicaid program, making Medicaid reimbursement to critical access hospitals even more vital.

The hospital community also will advocate that Medicaid Parents’ Coverage be restored to 100 percent of the federal poverty level to reinstate insurance coverage to 25,000 low-income Ohioans, and that the outpatient fee schedule be updated so that reimbursement serves as an incentive and not a roadblock for less-intrusive, cost-effective outpatient procedures. OHA looks forward to continuing its conversations with Gov. Strickland’s administration and with the legislature on these issues as the state budget begins to take shape.

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