Wednesday, July 11, 2001

Hospitals: We aid poor at loss

By Dan Klepal
The Cincinnati Enquirer

        University and Children's hospitals say they lost a combined $12 million last year in providing health care to poor people.

        The hospitals each issued reports to the Hamilton County Tax Levy Review Committee on Tuesday in which they state their “true” costs of providing indigent care.

        The reports are in response to a report issued to the same committee by vascular surgeon Dr. Kevin D. Martin. He said the hospitals have made more than $70 million in profits providing care to the poor over the past five years.

        The cost of providing indigent care is critical in determining how much of a tax increase may be placed on the November ballot in Hamilton County. The committee is considering a 21 percent increase, which would generate $217 million.

        University Hospital receives 80 percent of the levy, with Children's Hospital Medical Center getting the rest.

        The levy review committee has hired an outside auditor to consider the issue. His report is due to the committee today.

        Dr. Martin, a former member of the levy review committee, has said the levy, combined with cash from the federal Hospital Care Assurance Program (HCAP), has allowed the hospitals to make money off poor patients.

        His report was based on annual Medicare and Medi- caid cost reports hospitals are required to file with the state.

        Both hospitals say those reports don't tell the whole story.

        University Hospital makes three main assertions:

        • Dr. Martin's understanding of the purpose of HCAP is wrong. The hospital says HCAP is a grant to supplement indigent care and not, as Dr. Martin asserts, a funding source that should be used before local levy dollars.

        • The claim that the hospitals make a profit off indigent care is incorrect.

        • The statement by Dr. Martin that Hamilton County residents pay more to provide indigent care than those in other Ohio counties is wrong.

        “Because Dr. Martin's conceptualization of the issue is flawed, his facts are in error and his conclusions are unsupported by the real facts, his recommendations should not be given credence,” the University Hospital report concludes.

        The Children's Hospital letter agrees with the University Hospital letter and provides a balance sheet of expenses in providing indigent care.

        “(This) analysis includes costs that the HCAP program does not allow us to include ... and costs that are not permitted to be reported on the Medicaid cost report,” says the letter, signed by Scott Hamlin, chief financial officer at Children's Hospital.

        Dr. Martin, who had not reviewed the report in detail Tuesday, said many of the expenses being claimed by the hospitals should not be considered — items such as resident training, social work and physician support.

        “They want to talk about these costs, but they don't want to talk about the costs within the parameters of the (indigent care) programs,” Dr. Martin said.

        Al Tuchfarber, University Hospital's spokesman for the levy, said the report doesn't even consider all the costs in providing indigent care.

        “There are other costs not reported here, but they are even more difficult to measure and there just wasn't time,” Mr. Tuchfarber said. “So these are minimum estimates of our losses.”


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