Hospitals concerned about reimbursement rates

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(Host) Vermont hospitals are watching closely as Congress considers legislation designed to reshape the nation’s health care system.  

Hospitals are particularly concerned about reimbursement rates.  They say the rates paid by government programs like Medicare and Medicaid don’t cover the cost of providing care.  

Tom Huebner is president of Rutland Regional Medical Center.  Huebner says the problem has been magnified by the current recession because people are losing private health insurance when they lose their jobs.

(Huebner) "More and more of the folks who are coming to us for service no longer have Blue Cross or MVP or Cigna, and more of them have Medicaid or one of the other subsidized programs that are available.  That has an impact on us as a hospital because those programs pay far less for the services than a traditional commercial insurer does.  We’ve also seen an increase in bad debt and free care that we’re providing."

(Host)  Huebner says he hopes health care legislation will include changes to the system that will bring about better coordination between health care providers to eliminate waste.

Bea Grause of the Vermont Association of Hospitals and Health Systems says the major cost drivers in health care are increasing demand from aging baby boomers – and a culture that wants to provide every service available to patients.

Grause says there needs to be a national debate over balancing the cost of care with results.

(Grause) "We have evolved into very much a medical model and I think we really need to take a look at that to really think about how much health care we really need. And I think that’s part of the debate, looking at the United States in terms of clinical and medical outcomes versus how much we’re spending per capita." 

(Host)  Grause says hospitals haven’t taken a position on one controversial component of proposed health care legislation, which would expand the government role in providing coverage to the uninsured.  Hospitals say they’re waiting to see if the reimbursement rates under such a plan would be enough to pay for the care they provide.     

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