Largest, Busiest Ohio Public Hospital Faces Budget Shortfall that Could Force Cuts in Patient Services

Ohio's "largest and busiest public hospital," Cuyahoga County's MetroHealth Medical Center, faces a $21 million shortfall that might "reduce services" for some of the county's poorest residents, the Cleveland Plain Dealer reports. MetroHealth's "heart and soul has always been care for the poor," providing care around the city through primary care clinics, geriatric programs and an emergency and trauma division. However, less than one year ago, MetroHealth laid off 190 employees and "threatened" to end its participation in the state's Medicaid managed care program, raising concerns that additional cutbacks are forthcoming. Noting that staff cuts are likely not a viable solution, Paul Patton, MetroHealth's vice president of government and community relations, said: "We are at the point where staff cuts affect the quality of care. The last thing we want to do is cut quality of care. It's going to be a very, very difficult process." Thus, the Plain Dealer reports that the hospital "could be facing a loss of services if it can't come up with the $21 million." MetroHealth's financial troubles come during a "citywide health care crisis," during which two inner-city hospitals, St. Luke's Medical Center and Mt. Sinai Medical Center, have closed, and hospitals have faced a severe nursing shortage, widening holes in the city health safety net. MetroHealth officials now are looking into "survival tactics," including receiving reimbursement for Medicaid patients at Medicare rates, "which are typically higher." The Plain Dealer reports that the provision is a "narrow" one provided to hospitals that provide a "disproportionately" high amount of charity care. Last week, hospital officials met with the state Job and Family Services department, which oversees Medicaid, but the Plain Dealer reports that a decision on the provision might not "arrive until the first quarter of 2001." State legislation "designed to help hospitals that care for the poorest of the poor" -- which remains in committee -- also could alleviate the hospital's financial problems by adding $9 million to its budget. Hospital officials also have lobbied for changes to the Balanced Budget Act of 1997 that cut reimbursements to hospitals. Last year, the county gave MetroHealth $26.1 million, but county commissioners "were doubtful they could double the subsidy." County Commissioner Jane Campbell suggested that the hospital "needs an endowment." Commissioner Tim McCormack added that the county will begin to address the problem as budget hearings begin next week (McEnery/Exner, Cleveland Plain Dealer, 11/29).