Connect with us

Mississippi Today

Hospitals thought they’d get $450M in extra money this year. They’re actually getting much less.

Published

on

Hospitals thought they’d get $450M in extra money this year. They’re actually getting much less.

Mississippi hospitals, many on the precipice of closure, will be getting much-needed additional money this year.

But the amount they receive might be much lower than expected.

The Mississippi Division of Medicaid proposed changing the way it calculates some additional funding hospitals in Mississippi receive called “supplemental payments.” One of the funds, called the Mississippi Hospital Access Program payments, gives hospitals the difference between what Medicaid actually paid for services rendered and what Medicare would have paid for similar claims, offsetting losses incurred by standard Medicaid payments being too low.

But on Feb. 15, the Mississippi Division of Medicaid submitted a request to the Centers for Medicare and Medicaid Services to change that model to pay hospitals the difference between Medicaid rates and what an average commercial plan’s rate would have paid.

The goal was to generate more money for hospitals.

Tim Moore, president of the Mississippi Hospital Association, said the original estimate hospitals received from the Division of Medicaid for supplemental MHAP-generated funds after the change was around $450 million.

The most recent calculation, however, is $40.2 million.

“The preliminary estimates from last fall were subject to change based on Mississippi-specific data, and those estimates were not submitted to CMS,” said Matt Westerfield, communications officer at the Division of Medicaid.

Currently, Mississippi hospitals have two sources of funds called “supplemental payments” — the MHAP and disproportionate share hospital, or DSH, payments. These funds are a combination of federal and state money.

Since it was created in 2015, MHAP has yielded half a billion dollars to Mississippi hospitals, or about 8.3% of Medicaid spending in the state.

The problem with using average commercial reimbursement rates for a new calculation for MHAP payments is that Mississippi’s insurance reimbursement rates are so low, said Moore.

And that’s not all: Because of a complex rule about hospital funding limits, hospitals will receive $95 million less in the second type of supplemental payment (DSH) this year.

For hospitals that mostly serve patients from low-income backgrounds, DSH payments help hospitals recoup the cost of providing care to patients who cannot afford to pay. The total amount for Mississippi hospitals averages around $230 million each year, according to Moore.

“It’s a swap, in order to maximize dollars,” Moore said. “There’s not one lever you pull that doesn’t affect anything else.”

So, after accounting for the decrease in DSH funds, additional MHAP payments and one-time pandemic emergency relief funds, hospitals could net a total of $96 million in extra funds.

Lawmakers are also currently considering a bill that would give an additional $80 million in federal COVID-19 relief funds to hospitals.

Earlier this year, the Association projected that Mississippi hospitals would need a total of $230 million in additional funding to fill their financial gaps and sustain operations. Even with the grants, Mississippi hospitals are about $60 million short.

But the money’s got to come from somewhere, Moore said. Over a third of rural hospitals are on the brink of closure and need desperate help.

“Hopefully, the Legislature will increase the $80 million to a higher number,” Moore said.

Lt. Gov. Delbert Hosemann and Speaker Philip Gunn did not respond to questions about whether lawmakers would consider appropriating more money to hospitals by Wednesday afternoon.

And even if hospitals do get enough from additional supplemental payments, it’s possible that small, rural hospitals most in need of help will get the least funding.

Under the new proposed MHAP supplemental payment model, the payments are adjusted based on average commercial insurance rates. But that’s not a statewide average — that’s an average for each hospital.

So, a hospital’s extra MHAP payment will depend on how much it gets reimbursed on average by commercial insurers. And according to Mike Chaney, state insurance commissioner, that isn’t always equal.

“There are some hospitals, especially in the rural part of the state … that do not get paid on the same level that urban hospitals get paid for health care,” he said.

Currently, Medicaid is waiting on CMS approval for the change to MHAP payments.

“Medicaid has pushed for a rapid process, if there is such a thing,” Moore said. “They’ve impressed upon CMS the urgency of getting this done.”

But he stressed that if Medicaid was expanded, Mississippi’s hospitals wouldn’t be in this state.

“It doesn’t fix all the problems, and we’ve never said it would … but our hospitals wouldn’t be in as big a deficit as they are today,” he said. “The hole has gotten bigger and bigger and bigger. And now you’ve got to have money to fill the hole.”

This article first appeared on Mississippi Today and is republished here under a Creative Commons license.

Did you miss our previous article…
https://www.biloxinewsevents.com/?p=223841

Mississippi Today

On this day in 1997

Published

on

mississippitoday.org – Jerry Mitchell – 2024-12-22 07:00:00

Dec. 22, 1997

Myrlie Evers and Reena Evers-Everette cheer the jury verdict of Feb. 5, 1994, when Byron De La Beckwith was found guilty of the 1963 murder of Mississippi NAACP leader Medgar Evers. Credit: AP/Rogelio Solis

The Mississippi Supreme Court upheld the conviction of white supremacist Byron De La Beckwith for the 1963 murder of Medgar Evers. 

In the court’s 4–2 decision, Justice Mike Mills praised efforts “to squeeze justice out of the harm caused by a furtive explosion which erupted from dark bushes on a June night in Jackson, Mississippi.” 

He wrote that Beckwith’s constitutional right to a speedy trial had not been denied. His “complicity with the Sovereignty Commission’s involvement in the prior trials contributed to the delay.” 

The decision did more than ensure that Beckwith would stay behind bars. The conviction helped clear the way for other prosecutions of unpunished killings from the Civil Rights Era.

This article first appeared on Mississippi Today and is republished here under a Creative Commons license.

Continue Reading

Mississippi Today

Medicaid expansion tracker approaches $1 billion loss for Mississippi

Published

on

mississippitoday.org – Bobby Harrison – 2024-12-22 06:00:00

About the time people ring in the new year next week, the digital tracker on Mississippi Today’s homepage tabulating the amount of money the state is losing by not expanding Medicaid will hit $1 billion.

The state has lost $1 billion not since the start of the quickly departing 2024 but since the beginning of the state’s fiscal year on July 1.

Some who oppose Medicaid expansion say the digital tracker is flawed.

During an October news conference, when state Auditor Shad White unveiled details of his $2 million study seeking ways to cut state government spending, he said he did not look at Medicaid expansion as a method to save money or grow state revenue.

“I think that (Mississippi Today) calculator is wrong,” White said. “… I don’t think that takes into account how many people are going to be moved off the federal health care exchange where their health care is paid for fully by the federal government and moved onto Medicaid.”

White is not the only Mississippi politician who has expressed concern that if Medicaid expansion were enacted, thousands of people would lose their insurance on the exchange and be forced to enroll in Medicaid for health care coverage.

Mississippi Today’s projections used for the tracker are based on studies conducted by the Institutions of Higher Learning University Research Center. Granted, there are a lot of variables in the study that are inexact. It is impossible to say, for example, how many people will get sick and need health care, thus increasing the cost of Medicaid expansion. But is reasonable that the projections of the University Research Center are in the ballpark of being accurate and close to other studies conducted by health care experts.

White and others are correct that Mississippi Today’s calculator does not take into account money flowing into the state for people covered on the health care exchange. But that money does not go to the state; it goes to insurance companies that, granted, use that money to reimburse Mississippians for providing health care. But at least a portion of the money goes to out-of-state insurance companies as profits.

Both Medicaid expansion and the health care exchange are part of the Affordable Care Act. Under Medicaid expansion people earning up to $20,120 annually can sign up for Medicaid and the federal government will pay the bulk of the cost. Mississippi is one of 10 states that have not opted into Medicaid expansion.

People making more than $14,580 annually can garner private insurance through the health insurance exchanges, and people below certain income levels can receive help from the federal government in paying for that coverage.

During the COVID-19 pandemic, legislation championed and signed into law by President Joe Biden significantly increased the federal subsidies provided to people receiving insurance on the exchange. Those increased subsidies led to many Mississippians — desperate for health care — turning to the exchange for help.

White, state Insurance Commissioner Mike Chaney, Gov. Tate Reeves and others have expressed concern that those people would lose their private health insurance and be forced to sign up for Medicaid if lawmakers vote to expand Medicaid.

They are correct.

But they do not mention that the enhanced benefits authored by the Biden administration are scheduled to expire in December 2025 unless they are reenacted by Congress. The incoming Donald Trump administration has given no indication it will continue the enhanced subsidies.

As a matter of fact, the Trump administration, led by billionaire Elon Musk, is looking for ways to cut federal spending.

Some have speculated that Medicaid expansion also could be on Musk’s chopping block.

That is possible. But remember congressional action is required to continue the enhanced subsidies. On the flip side, congressional action would most likely be required to end or cut Medicaid expansion.

Would the multiple U.S. senators and House members in the red states that have expanded Medicaid vote to end a program that is providing health care to thousands of their constituents?

If Congress does not continue Biden’s enhanced subsidies, the rates for Mississippians on the exchange will increase on average about $500 per year, according to a study by KFF, a national health advocacy nonprofit. If that occurs, it is likely that many of the 280,000 Mississippians on the exchange will drop their coverage.

The result will be that Mississippi’s rate of uninsured — already one of the highest in the nation – will rise further, putting additional pressure on hospitals and other providers who will be treating patients who have no ability to pay.

In the meantime, the Mississippi Today counter that tracks the amount of money Mississippi is losing by not expanding Medicaid keeps ticking up.

This article first appeared on Mississippi Today and is republished here under a Creative Commons license.

Continue Reading

Mississippi Today

On this day in 1911

Published

on

mississippitoday.org – Jerry Mitchell – 2024-12-21 07:00:00

Dec. 21, 1911

A colorized photograph of Josh Gibson, who was playing with the Homestead Grays Credit: Wikipedia

Josh Gibson, the Negro League’s “Home Run King,” was born in Buena Vista, Georgia. 

When the family’s farm suffered, they moved to Pittsburgh, and Gibson tried baseball at age 16. He eventually played for a semi-pro team in Pittsburgh and became known for his towering home runs. 

He was watching the Homestead Grays play on July 25, 1930, when the catcher injured his hand. Team members called for Gibson, sitting in the stands, to join them. He was such a talented catcher that base runners were more reluctant to steal. He hit the baseball so hard and so far (580 feet once at Yankee Stadium) that he became the second-highest paid player in the Negro Leagues behind Satchel Paige, with both of them entering the National Baseball Hame of Fame. 

The Hall estimated that Gibson hit nearly 800 homers in his 17-year career and had a lifetime batting average of .359. Gibson was portrayed in the 1996 TV movie, “Soul of the Game,” by Mykelti Williamson. Blair Underwood played Jackie Robinson, Delroy Lindo portrayed Satchel Paige, and Harvey Williams played “Cat” Mays, the father of the legendary Willie Mays. 

Gibson has now been honored with a statue outside the Washington Nationals’ ballpark.

This article first appeared on Mississippi Today and is republished here under a Creative Commons license.

Continue Reading

Trending