Kirk Long, chief executive officer of NeuroMedical Center Hospital in Baton Rouge, predicts this year's thwarted battle merely sets the stage for a future one. "Health care providers can't rely on found money to continue financing gaps in Medicaid funding," he says.
Long, who helped build Park Place Surgical Center in Lafayette, also is the executive director of the Louisiana Association of Focused Care Facilities, which represents the state's 16 specialty hospitals.
The original bill, proposed by Rep. Sidney Mae Durand of Parks, called for a one half of 1 percent tax on gross revenues gathered by most health care providers in the state. The bill was proposed on behalf of Gov. Kathleen Blanco's administration.
The state hospital association, however, countered with a proposed bill that would have taxed only small "boutique" hospitals, facilities that concentrate on providing specific care. Under that plan, rural and community hospitals that treat indigent patients would have been exempt from the new tax.
In Lafayette, there are four specialty hospitals, including Park Place, Heart Hospital of Lafayette, Lafayette General Surgical Center (operated in partnership with Lafayette General Medical Center) and Lafayette Surgical Specialty Hospital. The recently opened hospitals compete for patients with the large hospital providers, including Lafayette General Medical Center, Our Lady of Lourdes and Medical Center of Southwest Louisiana.
And they are succeeding.
The infighting over the proposed tax highlights a growing enmity between the large hospital health providers and the doctor-owned specialty hospitals. The large hospitals argue that the specialty centers are siphoning off profitable procedures, like heart surgeries, that help pay for loss leader trauma units and burn wards. And since the specialty hospitals don't accept indigent patients, they avoid the cost of absorbing care for the uninsured.
Long says Durand's bill, by her own admission, was introduced to jumpstart a discussion about self-taxation of the hospital industry.
"It's obvious there is a need for hospitals to solve revenue problems," Long says. He equates the problem to challenges faced by nursing homes in the 1990s; the nursing home industry responded by taxing itself and placing the money in a trust that receives matching funding from the federal government. "The feds have restricted many of these matching fund programs," Long says, but they are still available for health care. "It's a big opportunity for hospitals and other health care providers to raise revenue."
The large health care providers might be wary of a tax that would raise matching funds, says Joe Donchess, executive director of the Louisiana Nursing Home Association. The industry in 1992 was a "reluctant proponent" of a bill passed to tax the nursing homes, but only because the matching funds were supposed to be funneled back to the nursing homes.
That happened for a couple of years, Donchess says, before the Foster administration began diverting the money to other health care programs.
He estimates that the nursing home industry alone raises $67 million a year, money that is matched by the federal government. The tax also applies to the mental health care and pharmacy industries, which raise a collective $30 million annually that's matched by the feds.
"We are what is called the cash cow of state government," says Donchess. The nursing home industry has paid some $770 million in taxes, generating $1.8 billion in federal matches.
A bill proposed this year would return those matching funds to the nursing home industry, Donchess says.
On the other hand, he adds, he does not think the federal government will allow Louisiana to tax only one segment of the industry ' like specialty hospitals ' in order to receive matching grant money.
He says the large hospitals might be more agreeable to a provider tax, but only if the Blanco administration will promise in the language of the law that the money collected goes to the hospitals that provide indigent care.
Long argues that an LSU study shows that only 2.1 percent of the total cost spent on providing health care in this state is spent on indigent care at the largest community hospitals. That study, conducted by Donald Smithburg, chancellor of the LSU hospital system, shows that the national average is 6 percent.
"The charity hospitals take care of the vast majority of indigents [in Louisiana]," Long says, noting that the for-profit Medical Center of Southwest Louisiana currently accepts no Medicaid patients, while the non-profit Our Lady of Lourdes pays no taxes.
He adds that the focused care association had no problem with Durand's broad-based hospital tax, agreeing that it was time for hospitals to help fill in funding gaps.
Under the state association plans, money raised through a hospital tax would be returned to the community hospitals to help pay for the treatment of the uninsured and to raise their Medicaid rates, says Burton Dupuis, chief executive officer of St. Martin Hospital. His facility would have been exempt under the hospital association plan.
The debate is just getting started. After multiple requests for comment, John Matessino, state hospital association president and CEO, would only say, "We are still discussing positive health care reform with the administration and are optimistic."
Lafayette Parish School Board member Greg Awbrey deserves an attaboy for his unexpected vote during Wednesday’s meeting approving a mediation session between the board and Superintendent Pat Cooper.
The cable television network's suspension of Duck Dynasty patriarch Phil Robertson from the hit reality show has drawn criticism from the governor of Robertson's home state.
The State Bond Commission gave preliminary approval to the borrowing plan Thursday without objection.
The Pediatric Clinic is housed in the same location previously closed by state budget cuts in June 2012.
Three-term Louisiana senator facing tough re-election battle is next in line for Energy Committee chairmanship.
In a letter distributed during Wednesday night's meeting, Lafayette Parish School Board member Shelton Cobb, in his final meeting as board president, called on his fellow board members to start focusing on the children and stop battling Superintendent Pat Cooper.
Here's your daily look at late-breaking national and international news, upcoming events and the stories that will be talked about Thursday, December 19, 2013
Joshua Dore of Breaux Bridge was sentenced Tuesday to 1.5 years in prison for counterfeiting, according to a press release issued by U.S. Attorney Stephanie Finley’s office on Wednesday.
School super Pat Cooper alleges Lafayette Parish School Board member Mark Allen Babineaux, an attorney, publicly disclosed the details of a closed-door executive session.
Sun Belt commissioner presents title and practice gets under way in preparation for Saturday
Kerry Bertrand’s charge was upgraded Tuesday by an Acadia Parish grand jury from manslaughter to second-degree murder for his alleged role in the drowning death of his stepdaughter, Skylar Credeur.
Sean Payton announced Wednesday that veteran Shayne Graham was New Orleans' new kicker, and that rookie Terron Armstead would get his first start at left tackle.
Should new parents be required by law to attend special classes before being permitted to raise their child? It’s an idea state Rep. Regina Barrow, D-Baton Rouge, is seriously considering.
The agenda for Wednesday’s meeting of the Lafayette Parish School Board tells it all: The board has lost sight of its elected purpose.
A public Mass will be held Thursday in New Orleans for artist George Rodrigue, who died Saturday of cancer at age 69.
Eight former employees of The Times-Picayune have sued the newspaper and parent Advance Publications Inc., alleging their layoffs violated a longstanding "job security pledge" and age discrimination laws.
Gov. Bobby Jindal's administration hasn't done an independent performance review of its $363 million privatization contract for mental health and addictive disorder treatment services.
"Whether it's the tackle position, whether it's a player on defense ... we're going to look closely at what our options are and what gives us the best chance."
Get to Cajun Field today and show your bowl-bound pride
In the end, edge to Tulane, but the 12th man could be the deciding factor.
Says ATC Commissioner Troy Hebert, “Obviously, they are not responsible enough to have the privilege of selling alcohol. This blatant disregard of the law will not be tolerated.”
Louisiana's Department of Education isn't properly monitoring the state's voucher program to make sure students are placed in private schools that demonstrate student achievement and success, according to an audit released Monday.
Five members of the Lafayette Parish School Board are facing potential fines of as much as $1,400 for excessive absences from board meetings in 2013.
Acadiana (14-1) broke the state championship record for points and rushing yards, rolling up 670 yards. Photo by Buddy Delahoussaye
The artist who chronicled Cajun life and later found fame with his enigmatic “Blue Dog” images died Saturday in Houston after a long battle with cancer.