Three private, nonprofit health systems have challenged the "equity in state funding" provided to the Virginia Commonwealth University and University of Virginia health systems to compensate them for treating indigent patients and teaching graduate medical students. In a presentation to state health and budget officials this fall, the Sentara, INOVA and Carilion health systems said they operate private teaching hospitals and Level 1 trauma centers in Norfolk, Fairfax County and Roanoke that receive less than one-eighth of the public compensation given to VCU and U.Va. for indigent care and medical education ? $29.2 million compared with $243.9 million for the public hospitals in the last fiscal year.
Vermont was supposed to be the beacon for a single-payer health care system in America. But now its plans are in ruins, and its onetime champion Gov. Peter Shumlin may have set back the cause. Advocates of a "Medicare for all" approach were largely sidelined during the national Obamacare debate. The health law left a private insurance system in place and didn't even include a weaker "public option" government plan to run alongside more traditional commercial ones. So single-payer advocates looked instead to make a breakthrough in the states.
Thousands of Greater Cincinnati patients of UC Health may be shopping for new doctors in the new year as the region's largest medical system and United Healthcare fight over the terms of a contract to replace a deal that expires Dec. 31. The executive director of United Healthcare in Southwest Ohio and Northern Kentucky laid out the major problem to reaching an agreement: UC Health, he said, has asked for "a double-digit rate increase and to be paid significantly more than what other similar academic hospitals in Ohio and Kentucky are paid for providing the same services."
The Tennessee Supreme Court has ruled unanimously that hospitals must release liens against patients once they and their insurers have paid their full charges. The case was filed by three emergency patients against the Regional Medical Center in Memphis over the practice of refusing to release the liens after the bills had been paid. The high court said that even when the Med determined that another person might be liable for injuries it would still file a lien against the patients in the hope of recovering additional money. The case was initially dismissed, but was reinstated by the Court of Appeals.
Emergency rooms are expensive for hospitals to operate because they have to remain open 24 hours a day, and there has to be staff on hand in case of, well, medical emergencies. In addition, emergency rooms are required by federal law to treat anyone walking in the door, no matter whether they can pay or not. And for many who are covered by insurance, the reimbursement for services provided to them is less than the cost of providing those services, especially in rural areas. Just over a year ago, we talked about how changes brought on by the Affordable Care Act could affect charity and rural hospitals. The standalone emergency room rule change was one possible idea to address the issue. Unfortunately, it doesn't appear to have had the desired result.
Beyond conducting their periodic evaluation of Womack Army Medical Center, one of the military's busiest hospitals, the inspectors who came here to Fort Bragg last March had a special task. A medical technologist had complained of dangerous lapses in the prevention of infections. The inspectors planned to follow up. But Teresa Gilbert, the technologist, said supervisors excluded her from meetings with the inspectors from the Joint Commission, an independent agency that accredits hospitals. "I was told my opinions were not necessary, nor were they warranted," said Mrs. Gilbert, an infection-control specialist.