HOSPITAL ADMINISTRATORS WAIT TO SEE ABOUT MEDICAL REFORMS

Hospital administrators are taking a "wait and see" attitude toward proposals to revamp Medicaid and give the state more control over the program.

Medicaid and Medicare are two "hot button" issues in the federal budget proposal now under debate in Washington. Proposed funding cuts in both programs could be devastating for the elderly, disabled and low-income, advocates say.

The pending budget proposal calls for Medicaid to become a block grant program. States would be allocated funding to be administered over a seven-year period. State lawmakers will be responsible for drawing up guidelines on who will be eligible for benefits and what coverage will be provided.

Medicare will see substantial funding cuts, if the current proposal is approved. Lawmakers are also proposing allowing people who are eligible for Medicare to opt instead for private insurance, which might provide coverage not available under the federal program.

But as lawmakers work to find compromises and the president threatens a veto, local hospital administrators say it's too soon to tell what the outcome may be.

"We don't know enough as to how the (Medicaid) would be administered," said Jim Wente, administrator of Southeast Missouri Hospital. "Right now it's entirely conceptual as to what the federal government is going to do."

"It sounds like there's still a lot of deals being made," said Dennis Fidler, president and CEO of St. Francis Medical Center. "I'm watching and trying to learn."

Republicans want to cut more than $180 billion from the Medicaid program by slowing spending growth over the next seven years.

"That's a big cut when it's the life blood for people who need health care but don't have resources," Fidler said.

He pointed out that cuts in Medicaid will adversely affect mostly women and children, and added that while he doesn't favor targeting the elderly over low-income women and children, "we should at least tend to the needs of women and children."

Wente said he's keeping a much closer eye on developments in the Medicare program.

"We know that's going to have some significant impact on hospitals across the country," he said.

The current proposal calls for cutting some $270 billion, including approximately $76 billion from funds used to reimburse hospitals for treating Medicare patients.

"When we're already getting paid less than cost, to have a reduction in the amount of increase that we were promised by lawmakers, that's a very negative thing," Wente said.

He said "the lion's share of remuneration" for medical services to Medicare patients comes from the federal government. Cutting those funds puts a greater burden on hospitals and will result in restricted access to health care for the elderly, he said.

About 35 percent of Southeast Missouri Hospital's patients are Medicare-eligible, Wente said. Fidler said about half of St. Francis's patients are Medicare-eligible.