The state of Mississippi has reached an unusual agreement with two hospitals in the Jackson area that requires them to provide a minimum amount of care to the poor in exchange for approval of their certificates of need.
State health officer Edward Thompson, M.D., said the two agreements represent the first time hospitals in Mississippi have agreed to conditional CONs. In 1990, 111-bed Woman's Hospital declined a similar offer by the state to open an obstetric unit, Dr. Thompson said.
"Some hospitals have not provided their fair share of care to Medicaid patients," said Harold Armstrong, director of Mississippi's CON program. In Mississippi, 20% of the state's 2.6 million residents are covered by Medicaid, and another 20% lack any healthcare coverage, he said.
Under the two separate agreements, the hospitals could lose their licenses for the services covered under the CONs if they don't comply, Dr. Thompson said. The state will monitor the agreements through annual reports that the hospitals must submit.
The two Jackson-area hospitals that agreed to the CON conditions are 100-bed River Oaks Hospital, Flowood, for a 10-bed birthing unit, and 280-bed Methodist Medical Center, for a 64-bed satellite facility in north Jackson.
Competitors of the two hospitals that opposed the CONs argued that if the state granted CONs to River Oaks and Methodist, they would skim paying patients and leave a greater number of uninsured or poor patients to be treated at other hospitals.
Methodist Medical Center agreed to four conditions for its satellite facility. They include that at least 5% of all the facility's patients must qualify under charity care rules and that a minimum 15% of its patients must be Medicaid recipients, Dr. Thompson said.
Another condition requires 5% of Methodist's obstetric patients to be charity-care cases, and 25% must be Medicaid patients.
"We believe (that), because of the demographics of the area and our mission, we will have no problem meeting those conditions," said Janice G. Baddley, a spokesman for Methodist.
The $27 million satellite facility is expected to open in the fall of 1995, she said. The hospital has until 1997 to meet those conditions, Dr. Thompson said.
River Oaks also agreed to four conditions for its 10-bed birthing unit. The unit was the subject of a lawsuit last year by two competing hospitals. The litigation resulted in the state attorney general's office ordering River Oaks to submit a CON. The hospital originally contended its unit would cost less than the $1 million threshold that triggered the CON process (Jan. 25, 1993, p. 6).
Its agreement requires that 25% of River Oaks birthing unit's patients be Medicaid recipients and that the hospital enter into transfer agreements with other hospitals to accept charity and Medicaid patients. The hospital has two years to reach those goals, Dr. Thompson said.
Mississippi, like most of the 39 states that have CON programs, has required hospitals or long-term-care facilities to provide a "reasonable amount of care" to the poor when it grants approval for providers to offer new services. National experts said some states have imposed conditions on certain CONs as one way to increase access to care for poor patients.