The hospital CEO explains the concerns behind a Statehouse rally last Wednesday.
They arrived in buses at the Statehouse on Wednesday afternoon, hundreds of Care New England hospital doctors, staff members, patients and community supporters with signs that said, “More cuts not RIte,” and “Protect Quality Patient Care – Stop the Cuts.”
They were there to protest Article 20 in the proposed 2011 state budget, which would cap RIte Care payments, reducing the system hospitals’ revenue by millions of dollars – on top of substantial state payment reductions already made in fiscal 2009 and 2010.
Constance A. Howes, president and CEO of Women & Infants Hospital, explained the worries behind the protest.
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PBN: How have the Care New England hospitals been doing in general this fiscal year?
HOWES: At the end of the first six months of this fiscal year [March 31], Women & Infants has lost $800,000 from operations, and Kent Hospital has lost $1.6 million from operations. This is due to a decline in patient volumes and reduced reimbursement from the state. We are also seeing an increase in uninsured patients, and almost half of the births at Women & Infants are now to women on Medicaid and RIte Care, which currently pay us about 79 percent of the actual cost of care.
PBN: What kinds of cuts has the state made already, in fiscal 2009 and 2010?
HOWES:In 2009 and 2010, Women & Infants has already sustained $8.3 million in cuts, including two 5 percent decreases in NICU (neonatal intensive care unit) payments, totaling $2.6 million. In that same time period, Kent Hospital sustained $4.5 million in cuts. Those cuts included net reductions in disproportionate-share payments and the change in the state’s payment methodology for Medicaid.
PBN: How does it affect Women & Infants to have your NICU reimbursement rates cut right now, with a new facility and, at least in the startup phase, higher operating costs?
HOWES: We are disappointed in the State reimbursement cuts for our most vulnerable patients in the NICU, both because they are targeted solely at Women & Infants [since it has the state’s only NICU] and because, during the certificate of need process, the state recognized the need for the new facility. Again, almost half of the patients in our NICU are covered by Medicaid or RIte Care.
PBN: What is the outlook in the 2011 budget, and how would it affect the hospitals?
HOWES: In the proposed 2011 state budget, Women & Infants faces another $21 million in cuts, including a $14 million blow that would come as a result of significant proposed reductions in RIte Care managed care payments. Similarly, Kent faces $5.1 million in cuts from RIte Care alone. These cuts only save the state less than a third of that amount, because of the substantial federal contributions for Medicaid. Women & Infants is a vital provider of services to RIte Care and Medicaid patients. The proposed cuts would reduce payments to a new low of 55 percent of costs. This means that for approximately half of our births, our payments would only cover a little more than half of our costs. Since 2007, Women & Infants has taken substantial steps to achieve cost savings; Women & Infants would be challenged to continue to serve our community as we have in the face of these reductions.
PBN: What did you hope to accomplish with this rally?
HOWES: We hope to stop the caps on RIte Care managed care payments, and to protect the vulnerable women and families served by RIte Care and preserve the 3,100 jobs at Women & Infants and the 6,000 jobs at Care New England.
