MACOMB — Local healthcare facilities are trying to safely navigate during a perfect storm of adversity.
Even as House Republicans voted Thursday to repeal and replace key provisions of the Affordable Care Act – also known as Obamacare – McDonough District Hospital CEO Kenny Boyd was speaking to members of the Macomb Chamber's Government Affairs Committee about the challenges the hospital is facing and how it is trying to address them without compromising patient care.
MDH has been dealing with cash flow concerns and uncertainties that have prompted administrators to make a goal of cutting more than $3 million by the calendar year end.
Among the challenges the hospital is facing are unpaid state employee health insurance payments going back two years; slow reimbursement of Medicaid claims; a $5 million overall reduction in Medicare reimbursement due to the ACA; and declining patient revenue due to lower university enrollment and other impacts from the state budget crisis.
Boyd highlighted two major concerns: slow reimbursement of Medicaid claims, and the unpaid state employee heath insurance payments.
He said MDH is continuing to care for about the same number of Medicaid patients, but without reimbursement from the state. “The state was ordered by the courts to pay Medicaid payments. So people were saying, 'Well, you're treating Medicaid patients and you're getting paid.'...But in reality, they slow pay. See, if they don't have the money, they can't write the check.”
About state employee payments, he said, “We have a lot of state employees inside of McDonough County, and hence we take care of a lot of those.”
Among three insurance companies that pay providers for state employee health claims, Health Alliance Insurance is the only one continuing to pay providers on time without reimbursement from the state. However, they are having to borrow to do so.
“They understand at some point that if providers aren't getting paid, they're going to quit seeing the state employees, and they understand the negative impact on employee wellness. Then what's going to happen is if a person has to pay up front when they go in, they're going to defer healthcare until it hits the wall and they have to go,” making their healthcare even more costly, and at the patient's expense, he said.  
“Health Alliance understands that...The question is, how long can they keep doing this?”

Reach Michelle Langhout via email at mlanghout@mcdonoughvoice.com or follow her on Twitter @mlanghout1.