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."
Thursday's Blogs from the Bog!
NJ lady beats Donald Trump; Israel calls up more troops; border hearings accelerated and more national and international news for Thursday, July 31, 2014.
State Rep. Lenar Whitney — one of a handful of Republican candidates vying for Louisiana’s 6th Congressional district — has been described by Cook Political Report analyst David Wasserman as one of the most “frightening or fact-averse candidate[s]” he’s ever met following her reaction to an interview last week.
Mid-August hearing dates have been set for dueling lawsuits over Louisiana's use of the Common Core education standards in public schools.
An investigation into the last-minute passage of a pension hike for the state police superintendent continues, despite Col. Mike Edmonson's decision not to accept the increase.
Safety Jairus Byrd practiced with the New Orleans Saints on Tuesday for the first time since his signing in March.
Sentencing has been delayed for a businessman who provided key testimony in the corruption case that resulted in the conviction of former New Orleans Mayor Ray Nagin.
The spectre of priest sex abuse has returned to haunt the Roman Catholic Diocese of Lafayette following the recent release of an investigative report by Minnesota Public Radio, revealing new allegations of another child predator hiding behind the clerical collar.
The sponsor of a Louisiana law that requires doctors that perform abortions to have hospital admitting privileges doesn't believe the provision is in jeopardy after a federal appeals court struck down a similar Mississippi law.
Louisiana's state school board has jumped into a lawsuit against Gov. Bobby Jindal that accuses the governor of illegally meddling in education policy through his efforts to block Common Core education standards.
Here's how one nationally recognized conservative political pundit reacted upon hearing the news Monday that the U.S. Chamber of Commerce was leaning toward an endorsement of Louisiana’s lone Democrat senator.
With the qualifying deadline for Lafayette Parish School Board elections quickly approaching, a series of candidate forums have been announced by the Lafayette Parish Public Education Stakeholders Council.
The investigation and potential prosecution of the man charged in the recent hit-and-run death of a Youngsville cyclist won’t happen overnight, according to local law enforcement officials.
Louisiana's state school board is holding a special meeting to consider whether to sue Gov. Bobby Jindal in an ongoing dispute over the Common Core education standards.
A bipartisan congressional deal to help improve veterans' health care access includes approval for new veterans clinics in Lafayette and Lake Charles.
It wouldn’t be a first, however, as the Chamber has thrown money behind Landrieu before.
The Democratic incumbent, seeking her fourth term in office, is a strong supporter of the Export-Import Bank, which helps finance exports of U.S. companies.
The world is a politically tense place these days with hot spots ranging from the Middle East to Ukraine. In Louisiana and Mississippi, where the political chessboard tends to be a lot less threatening and at times entertaining, this election season is living up to expectations.
Louisiana has joined nine other states in support of Indiana’s appeal of a federal judge’s ruling that the Hoosier State’s ban on sam-sex marriage violates the Constitution.
The Saints are being cautious in an effort to minimize risk of re-injury.
LSU Health Sciences Center says people with a common, hard-to-treat kind of lung cancer can join a new national trial to test drugs faster.
As New Orleans Saints coach Sean Payton and general manager Mickey Loomis spoke about the opening of training camp, steep, tree-covered mountains were in full view behind them.
The family of fallen cyclist Lon Lomas is speaking out after the release this week of the man charged with his death.
"The solutions are obvious: undo consolidation, or amend the charter to make this hybrid attempt at a new form of government work better."
The Board of Elementary and Secondary Education is considering whether to get involved in a lawsuit against Gov. Bobby Jindal for his attempts to undermine use of the Common Core education standards in Louisiana's public schools.