Mass. reform may have large impact on Southcoast

CHARLTON MEMORIAL HOSPITAL, along with its sister hospitals in the Southcoast Hospital Group, are facing increased financial difficulties. /
CHARLTON MEMORIAL HOSPITAL, along with its sister hospitals in the Southcoast Hospital Group, are facing increased financial difficulties. /

Community hospitals in the Fall River and New Bedford areas are worried that Massachusetts’ health care reform could ultimately prove costly to them.
And that, in turn, could mean reduced investments in new health services in those areas, according to the hospital group that controls three hospitals in the region.
The source of concern for Southcoast Hospitals Group – which includes St. Luke’s Hospital in New Bedford, Charlton Memorial Hospital in Fall River and Tobey Hospital in Wareham – is new limits on how much the state will reimburse hospitals for caring for uninsured residents.
Because of new requirements that Massachusetts adults have health insurance by year’s end, the state reduced the amount set aside for those reimbursements by about $200 million, figuring fewer people would go uninsured.
Southcoast Hospitals’ portion of the Health Safety Net Trust Fund has been cut by 32 percent, or $5 million, according to group spokeswoman Joyce Brennan. Yet, Brennan noted last week, the three hospitals have some of the highest rates of uninsured patients in the state and some of the highest volumes of emergency-room treatment.
And hospital officials said the number of uninsured residents in the area enrolling for health coverage ahead of the Dec. 31 deadline is lagging behind the rest of the state.
That means there may be more cases in which the Southcoast hospitals will have to pick up the medical costs if an uninsured patient who qualifies for the state-subsidized coverage fails to pay his or her hospital bill.
Over the last year, more than 200,000 state residents have signed up for health insurance in response to the Massachusetts Health Care Reform Act of 2006, which mandates that adults between the ages of 19 and 64 have health insurance coverage by the end of the year. State officials estimate that as many as 600,000 people were uninsured at the start of 2007.
For those who don’t have access to insurance through an employer and who have an income less than 300 percent of the federal poverty level – about $31,000 for an individual – coverage is offered through Commonwealth Care, a program in which the state subsidizes at least a portion of the premiums.
Rich Copp, spokesman for the Massachusetts Hospital Association, said the reform has placed the state’s health care industry and its residents in “uncharted territory.”
“It’s going to require ongoing monitoring,” he said.
Statewide, more than 133,000 people so far have enrolled in Commonwealth Care program, ahead of state projections.
The region covered by Southcoast isn’t seeing that same enrollment rate, Brennan said, though it’s not for lack of trying. The hospital group has attempted to reach out to the uninsured through billboard advertisements, fliers and brochures that emphasize the availability of affordable coverage.
Hospital officials are now trying to contact the 13,000 uninsured patients who used the three hospitals’ services in the previous 18 months. But many no longer live at the address given to the hospital at the time of their visit.
“It tends to be a transient population,” Brennan said. Nevertheless, more than 3,500 people have enrolled after being contacted.
Brennan said one thing is sure: If enrollments don’t pick up, officials will have to make some reductions, possibly in the area of investing in new medical services.
She noted that nearly 5 percent of the hospital group’s $440 million revenue in 2006 came from patients either paying their own bills or from reimbursements for patients who qualified for free care.
“This is going to have an impact on the budget,” Brennan said of the reduction of the Safety Net Trust Fund. •

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