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Opinion: More signs of financial trouble for hospitals

Opinion: More signs of financial trouble for hospitals
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The signals that Mississippi’s hospitals are headed for a day of financial reckoning continue to grow.

The Mississippi Today website reports that Merit Health Central, a hospital in Jackson, has moved “or is planning to move its cardiovascular services, neonatal intensive care unit and endoscopy to other Merit Health locations outside of Jackson.” It also is closing its burn center at Merit Health Central, the only such facility in the state.

One concern is that these moves will reduce the health care available to the Black-majority population in south and west Jackson and nearby rural areas of Hinds County. That is certainly undesirable, but the larger point is the financial considerations that went into the relocation of some services to Merit Health’s facility in suburban Flowood.

Mississippi Today’s story reported a number of issues at Merit Health Central, especially the Jackson hospital’s difficulty in keeping qualified medical workers. Few hospitals have avoided that problem since covid-19 arrived in 2020 and pushed medical care to the breaking point.

Merit Health Central, formerly called Hinds General Hospital, also took a financial hit from Jackson’s water crisis. The hospital had to bring in tankers to replace the city water that was unsafe or unavailable for several weeks.

The hospital also lost $16 million last year by providing care to patients without any health insurance. It was by far the largest loss of any of the Merit Health hospitals in Mississippi.

Equally significant are the financial difficulties facing Community Health Systems, the Nashville company that owns the Merit Health hospitals. Mississippi Today reported that Community Health reported a loss of $327 million for the first six months of 2022, and one ratings agency has downgraded the company’s bonds to “negative” status.

That’s probably why Merit Health Central, according to Mississippi Today, has ended its contract with travel nurse agencies, cut pay for its remaining nurses and dropped other employment incentives — at a time when most other hospitals are doing the exact opposite.

Merit Health Central is not the only Mississippi hospital in financial trouble. It is just the one receiving new advertisement about it.

To cite another example, Greenwood Leflore Hospital in the Delta has confirmed that it is running out of cash and is working on an agreement to be taken over by the University of Mississippi Medical Center. On a broader scale, UMMC and Blue Cross, the state’s largest medical insurer, remain at odds over compensation.

When it comes to the financial standing of hospitals, there may not yet be a fire. But there is an awful lot of smoke, and most likely plenty of hospitals in Mississippi are facing tough decisions about money vs. medical care.

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The challenge is to continue providing care, including to the uninsured, without running out of the money it takes to operate. If the last 30 months of the pandemic wild card have proven anything, it’s that something’s got to give.

Ideas? The state Republican leadership could acknowledge reality and expand Medicaid, bringing in an extra $1 billion a year. Refusing to do so carries a risk: Will it really take a couple of significant hospital shutdowns before expanding Medicaid is seriously considered?

A more likely solution will come from the federal government. For example, has Medicaid’s payments for treating uninsured patients increased to reflect higher employee costs at hospitals for skilled positions?

For the long term, though, if Americans want better and accessible health care, they will have to pay for it, whether through higher payroll taxes or higher insurance costs. Those are better options than more trillions of government debt.

—Jack Ryan, McComb Enterprise-Journal

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