(C) Idaho Capital Sun
This story was originally published by Idaho Capital Sun and is unaltered.
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Proposed Medicare cuts would hurt health care access for Idaho patients [1]
['More From Author', 'October', 'Christine Neuhoff']
Date: 2023-10-04
St. Luke’s Health System’s mission is to improve the health of people in the communities we serve.
That’s all people, regardless of personal choices or ability to pay. And St. Luke’s is not alone; Americans rely heavily on hospitals nationwide to serve as safety net providers, 24 hours a day, seven days a week.
Unprecedented challenges over the past three years have made our mission more challenging. Historic workforce shortages, supply chain disruptions and inflationary pressures have increased the costs for labor, pharmaceuticals and medical equipment, posing serious risks to hospitals’ ability to provide the quality care that our neighbors rely on.
Some lawmakers in Washington, D.C., would compound the problem through legislation that would cut billions of dollars from Medicare payments for services provided by hospital outpatient departments, including primary care, cancer treatment, home care and hospice services.
If passed into law, these so-called “site-neutral” policies would reduce patient access to vital health care services, particularly in rural and other medically underserved communities.
Idaho’s 35 rural counties account for about 80% of the state’s land area and approximately 30% of the state’s population. Many rural residents are impacted by social determinants of health – access to nutritious foods, transportation, and affordable housing among them – and rely on hospital outpatient departments, where, for example, a federal forest service worker is diagnosed with early-stage cancer, or an 84-year-old grandmother is found to have a rare heart condition. These are the departments that also ensure a much-loved neighbor is surrounded by friends and family in hospice care at home. And Idaho is far from alone in these scenarios.
Why are these site-neutral policies misguided?
Medicare already underpays hospitals for patient care. The proposed cuts would only widen that gap. At St. Luke’s, Medicare reimburses 66 cents for every $1 of care provided. These economics have driven many private providers to limit the number of Medicare patients they will see. Our hospital outpatient departments ensure that primary and specialty care are available for patients on Medicare and Medicaid.
So, the upshot is that even more patients could lose access to local hospital care – and rural residents and communities are most vulnerable. Most rural hospital funding comes from government programs like Medicare and Medicaid, and historical underpayment has contributed to the closure or conversion of more than 150 of the country’s rural hospitals in the past decade or so. Additional site-neutral cuts such as those proposed will worsen the problem, potentially forcing additional hospitals to close or further reduce or eliminate services.
Additionally, hospital outpatient departments treat sicker, more complicated, often chronic, lower-income patients than those treated in non-hospital settings. Moreover, the costs of hospital care consider the benefits only hospitals can provide, such as 24/7 emergency services, advanced medical equipment and standby capacity for natural disasters, pandemics and the like.
By mission and by law, hospitals provide care for vulnerable populations that otherwise would have no other access. St. Luke’s, for example, provides millions of dollars in charity and unfunded care annually and invests in the staff, equipment and technology needed to address clinical shortages and community health needs.
Citizens across our state and country must realize what is at stake. Congress should say no to these harmful “site-neutral” proposals, and instead work to strengthen access to care for all.
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