Underserved areas and their hospitals have benefited from DSH program, and other letters

Regarding the recent article, “Readmissions may say more about patients than care” (ModernHealthcare.com, Sept. 14), I was the medical director at a hospital in Gary, Ind., brought in to turn around the emergency department, so I have seen underserved areas up close. The hospital relied on disproportionate-share money to meet budget shortfalls. The program, intended to distribute funds to areas based on need, is being phased out under the Affordable Care Act. While imperfect, like many large government programs, DSH offers hospitals and the underserved populations they serve a financial lifeline. A solution might be to look at these historical payments and develop a funding formula to provide certainty outside the ACA on which these hospitals could budget.

Dr. Ernie Vesta

Chief medical offerVeritas Healthcare ManagementFort Collins, Colo.

The recent article, “Readmissions may say more about patients than care” (ModernHealthcare.com, Sept. 14) offers some very interesting findings, yet not surprising. Poorer populations face many challenges that others do not. One of those challenges is still something these hospitals can do something about, and that is the explicit and mostly implicit (unconscious) bias of providers that results in lesser care for racial and ethnic minorities. How do you solve these problems? You responsibly use computers to help with your cognition. Particularly in differential diagnosis and workup, algorithms have no racial or ethnic bias, and no contempt for the obese or the alcoholic.

Cameron Powell

CEOPhysician CognitionBoulder, Colo.