Cincinnati Hospitals Lost $12M In Providing Indigent Care in 2000, Reports Indicate

Cincinnati's University and Children's hospitals last week issued reports indicating that the facilities lost a combined $12 million last year by providing care to the uninsured, the Cincinnati Enquirer reports. The reports, which hospital administrators sent to the Hamilton County Tax Levy Review Committee, came in response to a study issued by Dr. Kevin Martin, a surgeon, that said the hospitals earned more than $70 million in net income providing indigent care (Klepal, Cincinnati Enquirer, 7/11). Martin's study alleges that the hospitals profited from the federal Hospital Care Assurance Program, which has provided more than $147 million to the hospitals since 1996 to cover indigent care, as well as $178.5 million generated by local taxpayers through a tax levy (Greater Cincinnati Health Watch, 7/3). The Enquirer reports that determining the actual cost of care is critical, as the committee is considering a proposal to increase the current levy -- of which University Hospital receives 80% and Children's receives the remainder -- by 21%, a move that would generate $217 million. The hospitals contend that Martin's study, which is based on Medicare and Medicaid cost reports the hospitals filed with the state, do not "tell the whole story." Specifically, the hospitals say Martin's assertion that HCAP funds are a "funding source" is not accurate; rather, hospital administrators say that those funds "supplement" indigent care. The University Hospital report states: "Because Dr. Martin's conceptualization of the issue is flawed, his facts are in error and his conclusions are unsupported by the real facts, his recommendations should not be given credence." Martin, however, said many of the expenses claimed by the hospitals "should not be considered." The levy committee has hired an outside auditor to "consider the issue" (Cincinnati Enquirer, 7/11).

Clinic Debate in Cleveland
In other Ohio news, the Cleveland mayor's office is continuing negotiations with the county-owned MetroHealth Medical Center to determine which patients the provider is required to treat. The city wants MetroHealth to treat any Cleveland resident, even if the patient is covered by an insurer that will not reimburse MetroHealth. MetroHealth has "refused," prompting the city to order all county health care workers to leave the facility by Aug. 1. The Cleveland Plain Dealer reports that Medicaid recipients in Cuyahoga County are required to join an HMO, but MetroHealth only contracts with two of the county's four managed care organizations. Although the city council last week called a hearing to address the issue, no one representing the mayor's office or MetroHealth attended the meeting. Mayor Michael White and MetroHealth President Terry White, however, released a statement to the council that said: "We will not be discussing this sensitive issue outside of our negotiations" (McEnery, Cleveland Plain Dealer, 7/10).