King's Daughters Medical Center is the lifeblood of the Brookhaven, Miss., community. Not only do we help those who may not be able to afford lifesaving health care, especially the elderly and poor, but we also are an important source of employment for the community.
But some members of the U.S. Congress are threatening additional cuts to Medicare hospital payments. These so-called “site-neutral” cuts significantly would reduce total Medicare payment for a variety of hospital services to the rate paid to physicians for providing the services in their offices or to the rates for ambulatory surgical centers. Our facility alone may lose more than $7 million — on top of cuts already in place due to sequestration and other budget-balancing efforts.
America's hospitals have greater responsibilities and requirements than other facilities. Hospitals are required to treat all comers — regardless of their ability to pay. Hospitals must be staffed 24 hours a day, seven days a week. Hospital staff and facilities are prepared to care for victims of large-scale accidents, natural disasters, epidemics and terrorist actions. And hospitals are subject to regulations from nearly a dozen different federal agencies, as well as multiple state agencies.
To pay for services provided in a hospital — with emergency department, surgical, nursing, emergency transportation and myriad other costs — at the same rate as services provided elsewhere does not make sense.
These cuts to Medicare payments, especially the cuts to evaluation and management services, would be particularly detrimental to safety-net hospitals, health systems and teaching hospitals. These facilities provide critical hospital-based services to low-income, vulnerable and chronically ill patients — many of whom are medically complex and have multiple comorbid conditions, such as diabetes or heart disease. Often, there are no other facilities in the community that can provide these services and manage the care of this extremely complex patient base.
In addition, freestanding physician practices and ambulatory surgical centers often refer more complex patients to hospital-based clinics for safety reasons, because hospitals are better equipped to handle complications and emergencies. These services typically are not available in their facilities. Cuts of the magnitude being debated in Congress would make it difficult for hospitals to continue to support existing outpatient clinics and provide a disincentive to create new clinics to support the growing needs of these populations.
Hospitals are frequently the only access point for care in urban and rural areas. America's hospitals are committed to ensuring that patients have access to the care they need at the right time and in the right setting. We urge Congress to oppose inclusion of these cuts in any legislation, and appreciate your continued support of King's Daughters and our patients.
Alvin Hoover is CEO of King's Daughters Medical Center in Brookhaven, Miss.