"BMC’s finances take turn for worse; Hospital faces first loss in five years" by Liz Kowalczyk, Globe Staff | July 12, 2009
Boston Medical Center, the state’s largest provider of medical treatment to the poor, is bracing for dramatic financial losses, which some fear will force it to slash programs and jeopardize care for thousands of poverty-stricken families.
The hospital projects that it will lose $175 million in the fiscal year starting Oct. 1, an 18 percent operating loss that is unusually large even in Massachusetts’ up-and-down hospital industry. The hospital estimates that it will close this year $38 million in the red, its first loss in five years.
Ironically, hospital officials blame the downturn partly on changes ushered in with the state’s groundbreaking mandatory health insurance law, which Boston Medical Center supported and that benefited many of its patients. As part of the law, the state phased out special subsidies for hospitals that treat large numbers of poor patients, a significant shock for Boston Medical Center.
About half the hospital’s 400,000 patients live below or near the poverty line, and English is not the first language of 30 percent of the patients. Its emergency room is the city’s busiest, with doctors and nurses renowned for their skill at treating victims of mayhem....
In addition to medical care, the hospital’s services for the poor include a food pantry for patients with special diets, legal aid, and an extensive roster of translators to assist non-English speaking patients. The Patrick administration has been negotiating with Boston Medical Center for nearly two years over whether to increase state funding for the hospital, but the state is grappling with a financial crisis of its own.
Need money? Go here.
State officials acknowledge that the hospital will receive significantly less next year for treating Medicaid, uninsured, and newly insured patients. But they point out that BMC has sizable reserves - about $190 million in unrestricted cash, according to the hospital. And, state officials believe, the hospital’s costs are much higher than those at other hospitals, raising questions about whether it can provide care more efficiently.
Related:
Why the Nation Doesn't Need Massachusetts Health Care
Massachusetts Health Care Takes a Seat on the S***ter
Sympathy for the hospital, which estimates that it treats 15 percent of all poor residents in Massachusetts, has waned among some legislators whose blue-collar districts include struggling community hospitals that have no cash savings and little philanthropic support to fall back on.
Meanwhile, Boston Medical Center, which is located in the South End, recently built a $119-million cancer center, restored two historic brick buildings for office space, and has started building a $189-million outpatient center.
“There’s no reserves in the hospitals that I represent. These hospitals are broke with a capital B,’’ Senator Michael Knapik, Republican of Westfield, told his colleagues during a budget debate last month. “You’ve got to understand that all healthcare doesn’t begin and end in Boston.’’
Hospital chief executive Elaine Ullian said in an interview last week that the shortfall doesn’t pose an immediate threat to the hospital’s survival, especially given that admissions have grown 7 percent and outpatient visits have soared 11 percent since 2006, when the state passed the law requiring almost all Massachusetts residents to have health coverage.
Then why the alarm?
But, she said, the state is now paying the hospital 64 cents for every dollar it costs to care for poor patients, which is “an untenable business model.’’ She said the board of trustees will decide on program cutbacks “if it gets to that point’’ and that “there are no sacred cows.’’
Ullian said she is hopeful that the state will figure out a way to increase the hospital’s funding....
Ullian said the state is paying for the health insurance program, now considered a possible national model by President Obama’s administration, “on the backs of the poor.’’
Keep this woman in mind for later below.
“It wasn’t supposed to be this way,’’ she said of the initiative to cover most of the uninsured. “There was never enough money put in to achieve this wonderful goal. Our hope and belief was that more money would come through. A principle of reform was that Medicaid rates would be higher, when in fact Medicaid rates went down rather than up.’’
Before the insurance law passed, the state paid Boston Medical Center, as well as Cambridge Health Alliance, large grants to care for the uninsured, which accounted for about 20 percent of Boston Medical Center’s patients. The administration also gave the hospital special payments to supplement regular Medicaid fees. As a result, the hospital made about a 7 percent profit on low-income patients, which it pumped back into its services. But both these programs have been phased out over the past three years, as the number of uninsured adults statewide has fallen.
It almost sounds as if what we had before was better.
Now, the state pays Medicare-like rates for the remaining uninsured patients, which make up about 10 percent of the hospital’s patients, and the state’s new subsidized health insurance plan, Commonwealth Care, pays rates similar to Medicaid for the newly insured. At the same time, after an initial increase in Medicaid rates, the state has cut them for many hospitals, including BMC.
The state paid the hospital $446 million in 2006 for caring for the poor and plans to pay it $317 million next year, at the same time that expenses and patient volume are growing. The hospital, said vice president Tom Traylor, could survive for one to two years by dipping into cash reserves to cover losses....
Yup, CUTTING CARE as demand increases. Some would call that rationing!
At the hospital food pantry last week, believed to be the only one at a hospital in the country, patients handed staff “prescriptions’’ that their doctors had given them. Doctors refer patients for specific problems, such as needing a low-salt diet for high blood pressure, but also if they discover a family simply doesn’t have enough to eat. The shelves were piled high with canned tuna, kidney beans and black beans, unsweetened applesauce, whole grain and regular pasta, peanut butter, boxed cranberry bread, and chocolate muffin mix.
Staff loaded a cart with some of these items, as well as orange juice with calcium and chicken breasts, for a single mother of four children, including a nine-year-old son with sickle cell anemia. His pediatrician wrote the prescription so “he would have healthy food,’’ said the woman, who didn’t want her name used. “I’m very glad the hospital has this kind of resource.’’
Oh, so it is a SUPERMARKET, too! No wonder costs are exploding!
And instead of caring for you, guess where the tax buck goes:
"Boston Medical sues state for funds; Hospital says money was used to finance health law" by Liz Kowalczyk, Globe Staff | July 16, 2009
Boston Medical Center filed suit yesterday against the state, accusing officials of illegally cutting payments made to the hospital for treating thousands of poor patients, a decision executives said could financially unravel the urban hospital’s key services....
The 26-page complaint.... argues that the state has financed its landmark health insurance law, a model for national healthcare overhaul, on the backs of poor residents by cutting money to the hospital that cares for many of them to pay for expanded coverage.
Related: Why Obama Wants A Health Care Bill This Year
A Healthy Insult For the American People
Can you afford $3,800?
The lawsuit could influence the national debate on healthcare by warning of the potential repercussions for hospitals that treat the poor. “This absolutely has implications for the national debate,’’ said Larry Gage, president of the National Association of Public Hospitals....
In interviews with the Globe last week, state officials questioned BMC’s request for more funding, considering the state’s extraordinary budget crisis and the hospital’s large cash reserves. The $1.5 billion the state paid the hospital in the past year went not just to the hospital, but also to its community health centers and health insurance plan, officials said.
BMC - where half of the patients earn less than $20,000 annually, 30 percent do not speak English, and one-third are on Medicaid - estimates that it will lose $175 million in the fiscal year starting Oct. 1, an 18 percent operating loss. By the end of this year, the hospital is likely to be $38 million in the red, its first loss in five years.
Hospital executives blame these projected losses on the state’s decision to slash the amount it pays BMC for treating a Medicaid patient in the hospital from $12,476 per admission last year to $9,323 this year and for paying what the hospital considers inadequate rates to care for uninsured patients and newly insured patients....
But we have TRILLIONS for BANKS and WARS!!!
The hospital’s successful building campaign has also drawn attention, particularly from legislators who represent communities with struggling hospitals in worse shape than BMC....
--more--"And remember Ms. Ullian? Like a rat deserting a sinking ship!
"Boston Medical Center’s chief to retire next year
Ullian, who lives in Brookline, has two adult children. Aside from spending more time with her family, she said she plans to get more deeply involved as a board member for three local companies, ThermoFisher Scientific, Vertex Pharmaceuticals, and Hologic."
Oh, she is going to CASH OUT, is she?
Just before the proverbial scitte hits the fan?
"Boston Medical credit rating may fall" by Bloomberg News | July 30, 2009
Wow, she got out just in time!
Boston Medical Center may have its credit rating lowered by Standard & Poor’s after it lost public funding as a result of the state’s universal healthcare law.
Not a good risk if you can't loot taxpayers!
The nonprofit hospital is getting less money from the state to cover the cost of uninsured patients because of the 2007 law that requires all Massachusetts residents to have health insurance, said Jennifer Soule, a Standard & Poor’s analyst in Boston.
The credit rating company put Boston Medical’s $378 million in tax-exempt bonds, rated A-, under review for a downgrade yesterday. “We hope the [state] administration will take notice of the red flag represented by this development,’’ Ellen Berlin, a spokeswoman for the hospital, said in an e-mail.
Why must EVERYTHING in AmeriKa be DEBT-RIDDEN and RELATED, 'eh?
CUI BONO?
Related: Municipal Bond Milking
Massachusetts was the first state to require all of its residents to get insurance or face penalties. The state also set up an agency to offer subsidized insurance in an effort to expand medical coverage to all residents. President Obama and Congress are considering similar measures as they negotiate a plan to overhaul the US healthcare system.
Boston Medical will get $139 million in so-called supplemental revenue from the state this fiscal year, which ends Sept. 30, down from $257 million last year, to cover the cost of treating uninsured patients, according to Soule. The hospital filed a lawsuit against the state this month in an effort to ensure the funding isn’t cut further, she said.
“It’s a huge portion of their revenue stream,’’ Soule said in an interview.--more--"
More problems Ms. Ullian bailed on (she knew):
"Biggest hospitals in Mass. face labor suits; Pay during breaks is under scrutiny" by Todd Wallack, Globe Staff | September 5, 2009
An upstate New York law firm sued Massachusetts’ largest hospital chains this week, alleging they systematically failed to pay employees for all the hours they worked....
One of the key allegations of the lawsuits brought against the five Massachusetts hospital operators is that they generally don’t pay employees during a 30-minute meal break, yet still expect the employees to work during at least a portion of the break time....
Is that common with all bosses, because that's been my experience everywhere!!!!
Although the unpaid time might only amount to a half-hour per employee per day, it could easily add up to tens of millions of dollars a year in compensation. The hospitals collectively employ more than 70,000 people.
Yeah, it ADDS UP QUICK! Gee, overcharge you on one hand, short-change you with the other!
No wonder Americans complain about health care -- and if Obama's tax hike disguised as reform goes through it will get even worse!
Lingle’s firm said it has signed up as plaintiffs about 500 hourly employees of Partners Healthcare System, Caritas Christi, Boston Medical Center, CareGroup, and UMass Memorial Health Care in Massachusetts. The suits are seeking back wages, interest, attorney fees, and other damages....
Yeah, Partners, the main health looter in this state!
A price-fixer, isn't that what they call it?
