Threatened L.A. Hospitals Seek State Assistance; Uninsured Patients Burden System


 
 

Melissa Evans | | Wednesday, October 10, 2007


LOS ANGELES -- Los Angeles County officials and executives from nine hospitals adversely affected by recent emergency room closures will make a plea for more money Thursday to a state commission that oversees Medi-Cal reimbursement rates.

The nine private hospitals have been losing millions of dollars due to the influx of uninsured patients and those covered by Medi- Cal, which has the lowest reimbursement rate for services in the country.

Harbor-UCLA Medical Center near Torrance has also been affected by the closure.

"We don't have the luxury of failing," said Jim Lott, executive director of the Hospital Association of Southern California, a trade organization that is spearheading Thursday's meeting. "If we see even one of these hospitals close, it will have a dramatic ripple effect on the whole health system. It would make a horrible situation even worse."

The August closure of the 48-bed emergency room at Martin Luther King Jr.-Harbor Hospital in Willowbrook was the tipping point of a long-simmering problem, Lott said. Four other hospitals or emergency rooms have closed in the last five years, forcing patients in some of the poorest areas near Hawthorne, Gardena and El Segundo into already-crowded hospitals that have had to absorb about 100,000 additional emergency room visits each year.

Centinela Freeman Memorial Health System based in Inglewood, along with eight other private hospitals identified by the county, have suffered serious financial repercussions. Some are considering closing their emergency rooms as early as next year, officials say.

This week's meeting will address only "part of the problem," said Deborah Ettinger, vice president of business strategies for Centinela, which also runs facilities in Marina del Rey and at LAX. "This is a county issue. The county needs to stand up to its obligation to take care of county patients."

The Los Angeles County Department of Health Services has negotiated contracts to absorb some of the financial impact of new patients, but hospitals are still bearing the brunt of it, executives say.

Hospitals must eat the cost of uninsured patients and receive only about 60 percent of what it costs to treat Medi-Cal patients from the state. The rates, which can vary widely, are negotiated between the hospital and the California Medical Assistance Commission.

The executives on Thursday will ask the commission to renegotiate their contracts because, they say, the circumstances of running their business have changed because of the recent closures. The discussion will take place at the regularly scheduled commission hearing in Sacramento.

"I think we have a pretty reasonable case," Lott said.

Some hospitals have threatened complete closure if the situation doesn't improve soon.

Downey Regional Medical Center will lose $12 million to $15 million this year from Medi-Cal patients alone, said Rob Fuller, the hospital's chief operating officer.

"We went from a situation that wasn't so great to a situation that is terrible" after the closure of King-Harbor, he said.

The emergency room at Centinela experienced an increase of about 10 ambulances a day after King-Harbor closed. Ettinger said they are tracking the financial situation closely.

Officials from the California Medical Insurance Commission wouldn't comment specifically on rates because they are negotiated privately. The seven-member commission only deals with inpatient Medi-Cal rates; outpatient services are negotiated through the California Department of Health Services, said Mervin Tamai, research director.

Lott and other hospital executives, however, say the commission's action could have a significant impact on financial viability of the hospitals. Any more emergency room closures could dramatically increase costs for all hospitals in the region, he said.

"This is a system-wide problem," he said. "If the system collapses, everyone is impacted."

melissa.evans@dailybreeze.com


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