Georgia hospitals that treat more than their share of poor and indigent patients are leaving no stone unturned as they seek new sources of revenues.
Like hospitals across the nation, those hospitals claim that their traditional revenue sources have been sapped by the Medicare payment limits imposed by the federal Balanced Budget Act of 1997.
Last week, Georgia Gov. Roy Barnes, with HCFA's blessing, freed up $164 million in federal and hospital matching funds to distribute to 44 hospitals that incurred unusually large losses from treating the poor and indigent between 1995 and 1999. During that period charity and uncompensated care cost those hospitals $1.5 billion, but the state's Indigent Care Trust Fund compensated them for only $975 million.
Georgia hospital officials credit the governor and Department of Community Health Commissioner Russ Toal with recognizing that the fund had an additional $64 million in hospital donations available, a sum they used to obtain $100 million in federal matching funds.
"There were a lot of pleasantly surprised individuals across the state when the governor announced this in September," said Joseph Parker, president of the Georgia hospital association.
Parker said nearly one-third of the $164 million total-about $52 million-will go to 1,200-bed Grady Memorial Hospital in Atlanta. Twenty-two rural hospitals will share $13.4 million, and the remaining 21 hospitals will divide $100 million.
Southwest Georgia Regional Medical Center in Cuthbert, Ga., a 25-bed rural hospital that didn't qualify for the extra money, instead received HCFA designation as a "critical access" hospital and will get about $200,000 more annually in Medicare reimbursements.
That critical access designation, a creation of the budget act intended to protect rural hospitals, has been granted to 76 rural, not-for-profit hospitals in 16 states. It lets hospitals switch to a cost-based method of reimbursement from Medicare's DRG-based system, which could mean more money for small, low-volume hospitals with large numbers of Medicare patients. To qualify, not-for-profit rural hospitals must apply to HCFA, agree to operate with 25 beds or less and transfer patients hospitalized for more than 96 hours. Southwest Georgia decertified 15 of its 40 beds to qualify.
Keith Petersen, the hospital's chief executive officer, said the critical access status is key to the financial health of his hospital, in Georgia's second-poorest county, Randolph County. "It helps us to stay open and gives our hospital an opportunity to survive," Petersen said.