WASHINGTON - Massachusetts teaching hospitals would lose $322 million, or about two-thirds of the federal dollars they receive for the training of medical residents, under a bipartisan proposal to tamp down the rising costs of Medicare and reduce the federal deficit.
Doctors not getting training?
Related: Slow Saturday Special: "Defense" Budget Exposes Debt Deal Debacle
But war got a double-digit increase?
The proposal, a slice of at least $1.6 trillion in spending cuts over the next decade being considered as negotiators try to forge a broad agreement to raise the nation’s debt limit, could be a body-blow to the region’s health care industry, a key part of the overall economy, analysts said.
It also promises to intensify the debate over the role of hospitals and the best way to deliver high-quality services to patients in a cost-effective manner.
For the hospitals, a $322 million reduction in Medicare reimbursements - a one-time cut that would be in force for at least a decade - would be devastating, industry representatives said. Training programs would be eviscerated, with fewer doctors taught and fewer specialties served....
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"Hospitals in Mass. feel fiscal squeeze; 16 reported losses; service cuts feared" July 10, 2011|By Robert Weisman, Globe Staff
Massachusetts hospitals are buckling under growing financial strains, with 16 - nearly a quarter of them - losing money last year, according to a new state report.
Thirteen hospitals in the state also suffered losses in 2009, but the deficits at many of them widened in 2010, the report from the state Division of Health Care Finance and Policy showed. Thirty others managed only modest profits last year.
Health care professionals say the financial squeeze is likely to tighten - especially for community hospitals and those that treat low-income patients - as Medicare and Medicaid payments are reduced. Reimbursements from such public payers account for about 60 percent of revenue at the average Massachusetts hospital.
“We are entering what is going to be a down period for hospitals, especially those without market clout,’’ said John McDonough, director of the Center for Public Health Leadership at the Harvard School of Public Health. “There will be far fewer independent, freestanding community hospitals. Some will close, some will be swallowed up by larger systems.’’
Obamacare benefited big business conglomerates? I'm not feeling so good.
So far, few have resorted to cutting medical services, but there are concerns that could happen....
The stresses were dramatized earlier this month, when 121-year-old Quincy Medical Center filed for bankruptcy protection days after its trustees voted to be acquired by a for-profit health care provider. In June, 126-year-old North Adams Regional Hospital made its own bankruptcy filing....
Related: Quincy Hospital Closing?
Other hospitals struggle with everything from high labor costs to aging facilities to the inability to borrow money for renovations and electronic medical record systems. Some have watched their doctors migrate to better-paying physicians organizations, or lost patients to private companies providing imaging and diagnostic services. And richer hospitals that can afford to invest in new technology and marketing have also drawn patients from less prosperous rivals.
“The haves continue to do well, the have-nots continue to deteriorate,’’ said Dennis D. Keefe, who is stepping down as chief executive of Cambridge Health Alliance this week to take over a hospital system in Rhode Island. “They can’t invest in their future.’’
Hard-pressed hospitals have done away with thousands of jobs over the past few years....
And yet state and Globe monthly unemployment reports always report gains.
Related: The Health of the Massachusetts Economy
What do you mean it is on life support?
“Most hospitals are not healthy,’’ said Timothy F. Gens, executive vice president at the hospital association in Burlington. “If you think about what it’s going to take to deliver health care in the future, many hospitals are in a dire situation.’’
Not all hospitals in the state fared badly last year. A number of large teaching hospitals posted substantial gains, led by two Harvard-affiliated institutions owned by Boston’s Partners HealthCare System Inc.: Massachusetts General Hospital reported a $181.3 million gain and its sister Brigham and Women’s Hospital registered a gain of $112.1 million. Beth Israel Deaconess Medical Center, another Harvard hospital, had an $84.2 million gain.
Dr. JudyAnn Bigby, secretary of the Executive Office of Health and Human Services, said some data in the state report shows stability or improvement. Overall hospital profitability increased, largely on the strengths of the teaching hospitals.
It looks like I need a third opinion.
“These numbers represent the height of the recession,’’ Bigby said. “The question is what is the business model for hospitals going forward.’’
As money-losing hospitals scramble to recover, they are counting on proposed changes in the way health care services are paid for, including a shift to global payments. Under global payment systems, insurers give providers annual budgets per patient, instead of reimbursing them for individual services and procedures. Such provisions are included in legislation proposed by Governor Deval Patrick.
It's called RATIONING!
See: The Massachusetts Model: Recipe For Rationing
To prosper under a global payment system, hospitals have to manage more efficiently, eliminate unnecessary tests, and reduce the number of patients who are readmitted.
I've really developed an aversion to global anything after what it has done to this planet.
There also will be changes in the way medical care is delivered, including more specialization and referrals by doctors to less expensive community hospitals. To survive in the new environment, hospitals have been banding together and joining with doctors groups to expand their reach and negotiating power with insurers....
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And what is this? Americans protesting?
"Health care players decry cuts pitched in Washington; Debt targets include Medicaid, Medicare" by Robert Weisman, Globe Staff / July 15, 2011
More than 50 state health care workers, executives, union activists, and lobbyists gathered on Beacon Hill yesterday to protest anticipated federal funding cuts they say would squeeze the state budget and devastate a business sector key to the Massachusetts economy.
While members of the hastily assembled coalition said they were still tracking fast-changing budget talks in Washington, D.C., some estimated the cuts being contemplated could drain $1 billion to $3 billion in annual health care funding from the state’s $30 billion budget, hurting everyone from the poor and elderly to doctors-in-training at teaching hospitals.
Standing on the State House steps, coalition members represented organizations including the Massachusetts Hospital Association, the Service Employees International Union, the consumer group Health Care for All, and the Greater Boston Interfaith Organization. Many held signs that read, “Fed cuts hurt care and jobs.’’
Speakers said that while it is difficult to gauge the full impact of fluid debt-limit negotiations, Massachusetts is almost certain to take a disproportionate hit because it collects additional federal money for a range of services, including training for medical residents and support for urban hospitals that treat large numbers of low-income patients.
“We are really scared and concerned about what might happen if Congress acts rashly and uses health care as the whipping boy’’ to rein in spending and reach a deal on raising the debt ceiling, said Lynn Nicholas, president of the Massachusetts Hospital Association in Burlington. “Medicare and Medicaid already don’t pay for their share of the costs.’’
The event, billed as a press conference, had the trappings of a political rally. It drew support from powerful health care players who are sometimes on opposite sides of the table, such as Partners HealthCare System, which operates the Harvard-affiliated Brigham and Women’s and Massachusetts General hospitals, and Blue Cross Blue Shield of Massachusetts, the state’s largest health insurer....
President Obama’s deficit reduction proposal, aimed at reaching a deal to raise the US debt ceiling, would reduce federal health care spending by about $340 billion over 10 years. That would be in addition to about $155 billion in projected cuts to Medicare, the government program that insures seniors, under the federal health care law passed last year. Proposals from congressional Republicans include far deeper cuts.
This government just stuck a finger up your you-know-where.
And that is the "FRIEND" DEMOCRAT!
The additional Medicare cuts would likely mean an estimated $322 million reduction in spending on medical resident training, a blow to teaching hospitals affiliated with the state’s four medical schools.
But the biggest hardship for Massachusetts, coalition members said, is likely to come from a reduction in federal funding for Medicaid, the health insurance program that covers low-income residents and is an important source of revenue for urban hospitals such as Boston Medical Center and Cambridge Health Alliance’s Cambridge Hospital....
Among the proposed Medicaid cuts is the elimination of taxes on health care providers that get matched by federal money. Massachusetts collects about $600 million each year through taxes paid by nursing homes, providers, and insurers. That money is paid into the state’s general fund, but much of it is returned to Medicaid programs and matched dollar-for-dollar by the federal government to pay for programs, including subsidized insurance for low-income patients. Critics of the taxes say they are a ploy to draw more federal dollars....
You know, like all the war propaganda and patsy terror plots.
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Related: No Choice With Obamacare
Not now.
