Rural hospitals look for bump in Medicaid payments

A special class of hospitals that includes Grays Harbor Community Hospital is looking for help from the Legislature to get payments for Medicaid patients that come closer to what it actually costs to treat them.

The designation “Sole Community Hospital” already allows rural hospitals meeting certain requirements to be paid 125 percent of a special negotiated rate for the care of Medicare patients, which is “always” lower than the cost of treatment, according to David Quigg, communications director for Community Hospital.

Twin bills in the Legislature would duplicate the designation at the state level.

“It’s really an exciting thing for our community, and it allows us to be sustainable long-term as a facility and continue to give the amount of care that we give,” he said.

Currently the hospitals, which include Community Hospital, Olympic Medical Center in Port Angeles, Samaritan-Moses Lake in Centralia and Providence Affiliate, also in Centralia, can charge Medicaid 100 percent of the special rate. The increase in reimbursement is expected to bring in nearly $8 million more for the hospitals over the next two years.

“What that will do is get us about to the federal Medicare level,” Quigg said. “That’s what makes it different, but at least it’s getting better. It’s getting the gap closer.”

The bills are being proposed in the state House and Senate, including sponsors Reps. Brian Blake, D-Aberdeen, Dean Takko, D-Longview, Steve Tharinger, D-Sequim, Kevin Van De Wege, D-Sequim, and in the Senate, Sens. Brian Hatfield, D-Raymond, and Jim Hargrove, D-Hoquiam.

A multi-million dollar hit to the state’s general fund may be a tough sell, but Quigg is optimistic.

“The thing that’s been really nice is the legislators that are representing this bill and representing Community Hospital know better than anybody the dire straits not only our community is in, but the health care providers in the community, how difficult it is for us to continue to see everyone and stay sustainable as an organization. I’m very optimistic, actually, because people understand the need,” Quigg said.

It’s unclear at this point exactly how much of the increased payments would be coming Community Hospital’s way if the bills do pass. It may be somewhat affected by Department of Corrections patients: Community is one of three of the Sole Community Hospitals that treats them. The Office of Financial Management estimates DOC would pay at least $271,000 more for medical treatment if the bill passes.

Quigg added local support has come from Greater Grays Harbor, Inc., and hospital employees writing letters.

“It’s been a nice community effort,” he said, adding special praise for the lawmakers pushing the bill. “It’s been spectacular, they’ve worked very hard to move this forward.”

The Senate version is awaiting a hearing in the Health Care Committee, while the House bill was referred to Appropriations.