St. Anthony Regional Hospital is one of the region’s largest employers, with a payroll of $32.4 million annually and approximately 730 employees. They are also the largest healthcare provider in the county, but have found themselves in the “tweener” position between smaller rural hospitals and larger urban ones. CEO, Ed Smith, says this positioning also means they serve a larger number of Medicare patients, with 1,090 of the 2,370 inpatient admissions being Medicare patients. During the recent Carroll Area Development Corporation’s (CADC) Access Washington trip, Smith was able to discuss with legislative aides and elected officials the Rural Community Demonstration Program that helps cover shortfalls created by Medicare reimbursements.
At the time St. Anthony joined five years ago, when the Affordable Care Act was enacted, the program included a seamless extension. A second extension was approved in December of 2016, but the newly-drafted rules created a reimbursement problem.
With the possibility of losing two fiscal years at $2.5 million each year, Smith says Access Washington was timed just right for this topic as the public comment period ended just one week before their trip.
This is critical, Smith says, because Medicare pays below cost in so many areas.
The hospitals are asking legislators to make the program extension retroactive to cover the shortfall. Senator Chuck Grassley said he would bring it up to Secretary of the Department of Health and Human Services, Tom Price, in an upcoming meeting. Grassley was true to his word and outlined what his specific legislative intent was when he authored this bill.
According to Smith, their best course of action now is to be patient and recognize this is how things are done in Washington, D.C. He says the federal rules will have to be finalized by the end of the government’s fiscal year on Sept. 30, but he expects that the Centers for Medicare and Medicaid Services (CMS) will want a decision by late August in order to begin implementation of the rules on Oct. 1.
