The Enid News and Eagle, Enid, OK

Local and State News

August 24, 2013

Uncertainty: Rural hospitals struggle with Medicare cuts, low patient counts


ENID, Okla. — Hospital care

When people present themselves to the hospital, the hospital must examine them, Dunham said. Once that has been done, the hospital has options. If the patient is determined not to have an emergency, hospital staff can send them away to see their physician. Dunham said they have not sent patients away, but are considering taking that action in the future if there is no emergency.

“Once you have determined they are not an emergency, you can ask them to pay up front,” Dunham said. “We haven’t done that, but some of our colleagues have begun that policy to reduce bad debt out of the emergency room.”

When people do not have insurance, the hospital is the first place to go when they are ill, Dunham said, and they usually wait until their illnesses are worse and cost more to treat.

At Share Medical Center, Allen said the average daily population in July was 1.7 people. The previous month is was 0.77.

“A lot has to do with patients not meeting Medicare necessities in the hospital,” Allen said. “Medicare has rules. We use a software program that follows to see if a patients meets certain criteria. If they don’t meet that, then Medicare will not pay for admission.”

Those patients are cared for on an outpatient basis, she said.

Less revenue

At Share Medical Center, cuts to the Medicare program over the years have whittled away the hospital’s margin, Allen said.

“We can’t cut ourselves to a profit,” she said.

In 2011, the hospital made cuts of $11 million. In 2012, the total of cuts came to a little more than $10 million. She also anticipates spending more than $2 million to upgrade electronic record-keeping required by Medicare. Funding will come partly from Medicare, and the hospital has spent $1 million of its funds to get the program going, she said.

Share Trust helped the hospital survive during tough times. Alva residents donate to the trust to help the hospital.

“We have a very, very supportive community that wants to see the hospital be successful. It’s a difficult time, definitely,” Allen said.

The refusal of Fallin to accept Medicaid expansion will cost Share Medical Center about $10,000 per month, Allen said. It’s money they can’t afford to lose, with no way to make up the funds, she said. Loss of funds through sequestration also financially has hurt the hospital.

 Share Medical Center recently entered a cooperative contract with St. Anthony Hospital in Oklahoma City, to be an affiliate hospital. Other hospitals in northwest Oklahoma also have entered contracts with St. Anthony. The contract allows Share to utilize St. Anthony resources it could not otherwise afford, Allen said. Share has started telemedicine programs, and a registered cardiologist comes from St. Anthony to Alva on a regular basis. Allen said Share is trying to keep services in Alva so patients don’t have to go out of town.

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