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Hospitals to Congress: Drop Payment Cap Proposal

John Commins, for HealthLeaders Media, September 14, 2012

Feldpush says approximately 200 safety net hospitals represent about 2% of all hospitals in the United States. However, they would absorb 15% of the cap reductions—a $150 million hit—owing to their patient mix, high facilities and operations costs, and a care delivery structure that relies heavily on outpatient clinics.

"That's 15% of $1 billion: 200 hospitals; 2% of hospitals; 15% of the cuts. That is a lot," Feldpush says. "You could pretty much say that it would be incredibly challenging to stake an institution to cuts of that magnitude without seeing negative consequences in terms of the services we could offer and the people we could serve."

Much of that disproportionate hit comes because large safety net hospitals in urban settings rely on extensive ambulatory care networks. "Among NAPH member hospitals, they have on average 20 outpatient clinics. This is intentional. We manage those hard-to-reach patient populations with very complex multiple co-morbidities," Feldpush says.

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1 comments on "Hospitals to Congress: Drop Payment Cap Proposal"


Lawrence Lewis, CEO, PMHD (9/19/2012 at 11:23 AM)
The proposed payment cap that would reduce hospital payments to the difference between hospital based ER visits and physician office patient visits, does not consider the burden that is placed on hospitals to see EVERY patient that arrives on campus seeking maedical care. It does not take into consideration the cost of maintaining a service 24X7 that is prepared to see patients of any condition and unknown medical history from a pulled chest muscle resulting from a cough or sneeze, to a blockage that could ultimately end up with open heart sugery. They do not consider the patients that walk in with a headache due to lack of sleep to a pain symptomatic of a brain aneurism. Proposed signficant changes to compensation structures should be researched thoroughly and based on the cost of providing the services that are being required of a hospital emergency rooms. This is why it's important for legislators to develop working relationships with the hospital associations that engage industry leaders in collaborating to develop sound proposals.