The Enid News and Eagle, Enid, OK

January 28, 2014

Expansion critical for Insure Oklahoma, Integris president says

By Phyllis Zorn, Staff Writer
Enid News and Eagle

ENID, Okla. — Eddie Herrman, president of Integris Bass Baptist Health Center, believes expansion of the Insure Oklahoma program among employers to provide coverage for lower-income residents is important to the health of Oklahoma hospitals and their patients.

Herrman was featured speaker at Monday’s Enid Rotary Club meeting. Stepping to the lectern, Herrman took note of the presence of the St. Mary’s Regional Medical Center CEO.

“I’m glad to see Stan Tatum here because, even though we’re competitors, we pretty much stand united on this,” Herrman said as he began to talk about the ramifications of the Affordable Care Act.

Herrman shared statistics from Oklahoma Hospital Association showing that in Garfield County, the Insure Oklahoma program provides coverage to 96 businesses, 85 employees and 72 individuals.

About 636,000 Oklahoma residents do not have health insurance, Herrman said. Despite the common belief that uninsured adults don’t have jobs, about 80 percent of them do work, but cannot afford health insurance premiums, he said.

The uninsured likely are to be 19 to 34 years old, Herrman said. About 3,300 uninsured adults live in Garfield County with income below 130 percent of the poverty level.

“We take care of everyone who comes through the door of our ER regardless of their ability to pay,” Herrman said.

Enid hospitals serve patients who live as far as three hours’ drive away, Herrman said.

“If these smaller hospitals are affected adversely, it won’t take much to see those hospitals become insolvent and they will disappear,” Herrman said.

Federal cuts are expected to mean $45 million less reimbursement to the two Enid hospitals, Herrman said.

“I can tell you right now, neither one of us can afford to take a $24 million or $25 million reimbursement cut and afford to continue,” Herrman said.

Herrman later said over a span of 10 years, the projected impact to the two Enid hospitals is $86.5 million in lost revenue, and the projected impact to all Oklahoma hospitals is $2.44 billion.

High-deductible plans, where the policy-holder cannot afford the deductible, are hospitals’ fastest-rising debt, Herrman said.

One Rotarian asked about an email circulating that says Medicare won’t pay for hospitalization if the patient is admitted “for observation.”

Herrman said Medicare does assign a larger share to the patient for outpatient care, and if the patient’s stay is less than two midnights, that is considered outpatient care.

“There is some truth to that,” Herrman said.