Letters: Rising Medicaid spending isn't a windfall for providers

Regarding “State Medicaid spending swells even as enrollment flattens,” it’s an interesting article, but when you look at who is making out on Medicaid reimbursement, it definitely is not the healthcare providers.

In Iowa, Medicaid managed-care organizations have seen annual increases in payment from the state (around 8% annually), while my hospital in the four years of Medicaid managed care has seen $2.4 million less in overall payments (representing almost 8% to 10% of our overall net revenue), while our volume has increased. In my opinion, it seems that the lower reimbursements to hospitals is just getting transferred to the administration costs of these for-profit insurers (where else would it go?)

So as far as what is driving up most of the costs, well it definitely cannot be what is being paid to provide actual healthcare services. Most of the money from this program now goes out of state to these managed-care companies.

I would agree that the costs of medications for Medicaid could also be a component, but aren’t some of these costs rebated by the manufacturers for most medications? If the state is not obtaining rebates, that could be part of the increase in medication costs.

This is just my take as head of a small critical-access hospital with about a 20% Medicaid population.

Matt Ives
Administrator and chief financial officer
Keokuk County Health Center
Sigourney, Iowa

The Oct. 7 Best Practices article, “Converting to plain language alerts helps avoid staff, patient confusion,” underscores why, throughout the decade, a growing number of hospitals have moved to standardized, plain language overhead codes.

The story about Piedmont Health in Atlanta is instructive for hospitals that have yet to employ a plain language system. Plain language alerts deliver better information clearly and quickly.

In addition, the codes can help hospital employees understand and apply overhead codes while working at multiple facilities throughout a health system. Moreover, with the high rate of mobility within the workforce, greater plain language adoption could expedite staff training for all hospitals and healthcare providers.

Since Missouri’s program launched in 2013, nearly 90% of hospitals have adopted plain language systems over their legacy alerting systems. More than half of Missouri hospitals have moved to plain language codes—or a hybrid system—for security-related alerts.

The original goals of standardized code implementation were primarily operational and quality-focused. However, with the significant growth in violence in hospitals, plain language codes are increasingly valuable in efforts to alert everyone in the hospital in an emergency. Under a plain language system, staff, patients and visitors can collectively gain situational awareness and be prepared to act if their safety is threatened.

Decoding this part of healthcare just makes sense.

Jackie Gatz
Vice president of safety and preparedness
Missouri Hospital Association