Copyright 2000 Plain Dealer Publishing Co.
The
Plain Dealer
October 28, 2000 Saturday, FINAL / ALL
SECTION: METRO; Pg. 1B
LENGTH: 581 words
HEADLINE:
FUND CUTS PUT STRAIN ON METRO HOSPITAL
BYLINE: By
REGINA McENERY; PLAIN DEALER REPORTER
BODY:
MetroHealth Medical Center shares a symbolic connection with the legions of
poor people knocking on its door.
The county-run hospital keeps getting
riddled by economic forces that threaten its solid reputation as a busy teaching
facility and safety net for the poor. Frustrated administrators are trying to
plug a hole in the dike by joining hands with Care Source, a Medicaid HMO based
in Dayton. The contract, which is expected to be finalized next week and to take
effect in February, will keep MetroHealth a player in a managed-care system that
has been bleeding red ink almost since its arrival in Cuyahoga County in the
early'90s.
If a deal is struck, the HMO contract will allow MetroHealth
to bill on a fee-for-service basis. Care Source has also agreed to assume some
of the risk for Medicaid patients. Both these concessions should boost Medicaid
reimbursements for MetroHealth, which by law must treat all patients regardless
of their ability to pay.
Meanwhile, the hospital is pursuing discussions
with Columbus legislators about contracting directly with the state for its
Medicaid dollars. Ohio oversees Medicaid, the state-federal insurance program
for the poor and disabled.
But even if a permanent solution is found to
the Medicaid shortfall, it can't begin to override the forces that continue to
chip away at Metro's bottom line.
The hospital's charity-care allocation
declined this year, but not the number of uninsured people seeking care.
Reimbursements from all payers, including Medicare, Medicaid and private
insurance programs, keep declining.
Cutbacks in graduate medical
education have driven dollars away from MetroHealth's labor-intensive
trauma, burn and neonatology divisions, while the loss of two East Side
hospitals has boosted the volume of patients using those services.
MetroHealth was also penalized because it can't invest in stocks. While
private hospitals are surviving on huge gains in investment income,
MetroHealth's operating losses, which have amounted to more than $20 million
since January, have not been offset by hefty stock returns.
Last
February, the hospital laid off 190 workers to balance its budget, but
MetroHealth President Terry White said there were no plans to issue more pink
slips this time. He said departments would probably lose positions through
attrition. The hospital employs 5,200 workers, nearly 1,000 of them nurses.
"It's frustrating," said Dr. Ben Brouhard, executive vice president for
medical affairs and chief of staff at MetroHealth. "We're here and we've chosen
to be here because we believe in the mission of MetroHealth. When we have
certain constraints upon the finances, when we have Medicaid HMOs that are
paying 29 and 30 cents on the dollar, it is just frustrating. To Metro's credit,
we have not compromised patient care. And we will not do that. You have to try
to be judicious in other areas, but you have to draw the line in the sand and
the line in the sand is patient care."
In fact, the hospital, which has
16 departments ranging from family medicine to trauma, and more than 400
doctors, is expanding to survive. With emergency room visits expected to total
73,000 by the end of the year, the hospital has decided to construct a new
emergency room that can accommodate up to 100,000 visits a year. Unofficial
reports are that it may be ready for operation by 2004.
A study supplied
by Chi Associates suggests the current emergency room was built to handle only
45,000.
LOAD-DATE: October 29, 2000
