Wednesday, June 28, 2000

Hospital to lose $12M in funding

University tops in indigent care

By Tim Bonfield
The Cincinnati Enquirer

        University Hospital stands to lose at least $12 million this fall as Ohio's biggest loser in proposed changes to a statewide hospital charity care fund.

        At issue: how to share $526.8 million from the Ohio Hospital Care Assurance Program (HCAP), established in 1988 to help hospitals that serve unusually high numbers of uninsured patients.

        The fund has been shrinking since 1997. But this year, the Ohio Hospital Association also has proposed changing the formula for how the money gets split.

        The proposed changes, which must be decided by Sept. 30, have urban “safety net” hospitals in Cincinnati and Cleveland crying foul. The changes also have drawn fire from Cincinnati City Councilman Charlie Winburn, who plans to introduce a motion today urging Ohio Gov. Robert Taft to step into the debate.

        “We don't like the out come. We hope it will be modified,” said Jack Cook, chief executive of the Health Alliance of Greater Cincinnati, which runs University Hospital.

        “We did anticipate a reduction, but the current plan falls far short of what should be expected to care for this patient population,” Mr. Cook said.

        Mr. Winburn said he is outraged that University Hospital, which provides far more care for the poor than any other hospital in Cincinnati, is facing the biggest cut in HCAP funding.

        “Twelve million dollars is a big drop in indigent care,” Mr. Winburn said. “If those people can't pay, I'm concerned about who gets stuck with the bill. The city?”

        The HCAP fund is created from a statewide hospital tax combined with federal matching funds. The pooled money gets redistributed to hospitals based on how much uninsured care they provide.

        Historically, the Ohio Hospital Association recommends a spending formula to the Ohio Department of Health. This year, the association has approved two formulas, one far more likely to pass than the other.

        According to the most likely formula, 11 Tristate hospitals would lose a combined $15 million in HCAP funds this year, with $12.3 million coming out of University Hospital alone.

        Nine hospitals would gain $10.6 million more than last year, with Children's Hospital Medical Center gaining $4.9 million. Overall, the region's hospitals would get about $4.4 million less for indigent care.

        Mary Yost, spokeswoman for the OHA, said there is no way to make every hospital happy with the HCAP program. Rising costs of providing care allowed many more Ohio hospitals to claim increased compensation from the HCAP fund, which in turn reduced the money available to big urban hospitals.

        “We wish we could get more money to MetroHealth (Medical Center n Cleveland) and University Hospital. They are important safety net hospitals,” Ms. Yost said. “But there are constraints on this program that are not of our making.”


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