“What would Emporia look like without a hospital?”
That’s the question Lieutenant Governor Lynn Rogers asked administrators and health care providers at Newman Regional Health during a stop on his statewide rural health care tour Friday afternoon.
Three Kansas hospitals have closed in the last eight years, including the Central Kansas Medical Center in Great Bend, Mercy Hospital in Independence and, most recently, the Mercy Hospital branch in Fort Scott.
“We can picture that already in three communities, and I know there are several others that are struggling,” Rogers said. “To me, it’s a moral imperative and an economic imperative to deal with this.”
With rural hospitals around the state struggling financially, Rogers is surveying rural areas like Emporia and Lyon County to see how a possible Medicaid expansion might benefit residents who receive health care in those areas.
Newman Regional Health has been a critical access hospital for several years, a designation given to eligible rural hospitals by the Centers for Medicare and Medicaid Services. That program aims to offer small hospitals in rural areas to residents that would otherwise be a long distance from emergency care.
As a critical access hospital, Newman Regional Health could see a funding increase of more than $2 million if an expansion was passed.
“I see many of our rural hospitals are operating in the negative margin, and when I look at what it could do possibly for Lyon County, you guys are spending $2.5 million or so that could come from Medicaid,” Rogers said.
Newman CEO Bob Wright said that was true, so long as the hospital’s overall patient volume did not increase dramatically as a result of an expansion of services.
“I still think it would be a net positive,” Wright said. “If the volumes stay the same, then yes, it would be a net positive. We’re budgeting about $300,000 total net income for 2019, but that includes grants and gifts. For operations, I think we’re looking at about $386,000 in loss.”
Medicaid funds could more than make up for the discrepancy in income, Rogers said. It would make sense to expand those services, he said, since the state has already lost out on $3 billion in taxes for not taking advantage of the expansion.
“The money we would get back on Medicaid is money we’ve already spent as taxpayers,” Rogers said. “We as a state have got to deal with rural health care and access and long-term profitability. When 85 percent of your hospitals have a negative margin, there’s not a business in the world that will stay in business with that kind of a margin.”
Rogers said Governor Laura Kelly has already drafted a bill that would expand Medicaid in Kansas — something former Gov. Sam Brownback declined to do in 2013. In Feb. 2017, the Kansas House voted 81-44 to extend Medicaid coverage to adults under the age of 65 who are not pregnant and have annual incomes up to 133 percent of the federal poverty level.
“The thing that we like to remind people is that 70 percent of the country have already [expanded Medicaid],” Rogers said. “We’ve expanded Medicaid in 34 states and Nebraska has just passed it by a vote in November.”
Rogers said he was also interested in hearing what issues were most important to local hospital administrators. Access to mental health services topped the list.
Chief Quality Officer Cathy Pimple said she did not feel like the hospital was able to adequately address the needs of people needing mental health services.
“We’re not keeping people out of crisis,” she said.
Currently, patients who come to the hospital in mental health crises are looking at a 3-4 day wait for a bed in a psychiatric facility. Newman Regional Health does not provide psychiatric services, but has four dedicated crisis rooms in the new emergency department expansion.
Project Manager Howard Blits said he was unsure that an influx in funding would immediately address those shortfalls. He said CrossWinds Counseling and Wellness has already found itself contracting out services that used to be done in-house when it comes to emergency services.
“Just because we begin funding the mental health center doesn’t mean they will be able to fill positions,” he said. “They’re at the point now that they’re contracting out services, so we find ourselves in a position where, a year ago, mental health professionals locally used to come and help us care for our patients. Now it’s all done by telemedicine.”
Still, those present agreed increasing access to medical care was crucial in addressing shortfalls in psychiatric care throughout the state.
Rogers urged constituents to get in touch with their local legislators to discuss expanding Medicaid, which he said would be a huge benefit to the state.
“This is just part of helping re-establish our medical community,” Rogers said. “This plan is built in that if the feds do change Medicaid rules, we can opt out. If we don’t want to participate later, we can choose not to do that. … For an ordinary Kansan to be able to have access to the latest medical technology, that’s going to be key. People want to get their medical care in their local community.”
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