UF Health:$37Million Cut Puts Hospital in the Red

[TheCat]

TALLAHASSEE | University of Florida Health Jacksonville will lose nearly $37 million under the Low Income Pool proposal Gov. Rick Scott submitted Tuesday to the federal government.
The hospital is among several safety nets across the state that would see drastic reductions in LIP-related funding under the governor’s plan, which is currently under review in Washington and would ultimately require the Legislature’s consent.

Jackson Memorial Hospital in Miami would see its funding decreased by $84.3 million, and Tampa General Hospital would lose $31.2 million. Both hospitals are still projected to be profitable under this scenario, just less so.

That is not the case for UF Health Jacksonville. A reduction of $36.6 million in LIP-related funding would wipe out the $2.5 million profit the hospital experienced in 2014 and put the center deep in the hole.

Chief executive Russell Armistead has said for weeks that this big of a cut could put the hospital out of business.

The U.S. Department of Health and Human Services’ Centers for Medicare and Medicaid Services is currently negotiating with Florida on the future of the LIP program, which last year funneled an extra $2.2 billion to hospitals and health clinics that treat the poor.

Although the governor’s proposal this week assumes the state will get approval for the same amount of funding for at least another year, federal officials have said the LIP program won’t be approved for more than $1 billion total.

http://jacksonville.com/news/florida/2015-05-28/story/funding-cut-37m-under-scotts-plan-would-put-uf-health-jax-red

[spuwho]

Having read Scott's proposals;

He wants to lessen UF Health's dependencies on LIP dollars by redistributing them (less overall) to the other health care centers in the city. Too much LIP is focused on just one major health center.

The issue is, how many of those other health care centers want more strings attached with those LIP allocations? And how far does a LIP patient have to go before they can find a place to get help? ie: will a former patient at Lem Turner & 295 drive all the way Baptist Beaches because they are the only ones with LIP dollars to burn?

Also, UF Health can't just say, "oh, OK, we are going to find 10,000 patients on private insurance to replace the 30,000 LIP patients you redistributed." Not unless they can build centers in more areas that have a higher percentage of private insurance. That doesn't happen in a year, not even 5, not with the way health care has to get licenses to build in certain areas.

So I get what he is proposing, but you can't expect UF Health to start packing up patients in ambulances and redistributing them around Jacksonville. Who steers the traffic? Who calls ahead and asks for a vacancy?

I know of hospitals outside of Jax who treat LIP patients in the ER as simply triage before shipping them off to the LIP aggregators soon after they get stable. It's a controversial subject in health care circles.

[Tacachale]

This is a very, very, very bad move.

[strider]

Is this really as bad as it is being made out to be?  If more people at the income level that the LIP money is supposed to have "covered" actually have Market Place insurance today, then would not less dollars be needed through LIP? If 70% of the people once only "covered" by LIP funds now have at least some sort of health insurance that will pay the hospital for needed services, then could not the hospital be OK with only 61 % of the LIP funding to cover the remaining 30% of the people "covered" under the LIP funds?

I know that a large percentage of people I know and have dealt with that never had insurance before now do and so rather than getting huge bills from the hospital that never get paid (if one assumes that is what is "covered" by the LIP funds) they get little ones that they actually do or at least try to pay. That would seem to reduce the hospital's dependency on the LIP funds.

It would be interesting to see the actual stats on how that 95 million was really spent and how Obmacare is really effecting the need for it. 

[urbanlibertarian]

I caught part of an interview on Action News Sunday this morning with a member of the state legislature.  If I understood him correctly, the feds are going to restore half the LIP funds and the state legislature during special session will try to fund 70% of the remainder and what's left would come from matching funds from a few federal programs.

[mtraininjax]

Sad, no one really seems to give a damn, either in Jax or on this board that the only Level 1 Trauma center in Jax could be having a problem. Don't get shot with a gun!

You have to believe that Baptist and St. Vincents are worried, they don't want to have to take the patients who go to Shands-Jax. That would kill their bottom lines.

[Tacachale]

This is a disaster and it's going to be felt by every one of us if it's not remedied, soon. The governor is antagonistic, and with the pending changeover in the Mayor's office it's unlikely we'll see enough local help pull through. That leaves the legislature, and the hope that Mayor Curry will jump on the issue, but that's a big task to conquer in a very short period of time.

[mbwright]

I don't see the governor nor the state picking up this tab.  Scott is too busy trying to ruin the state even more.

[simms3]

Dis-as-ter.

Who is this man running your state?

[spuwho]

Two issues here.

Scott wants to cut a sales tax on cell phones.

FL Senate doesnt want to approve any revenue reductions until its clear how much the Feds are going to provide for LIP. Then they will know what the state will be on the hook for.

Then they can go back, look at the revenue model and see if the cell phone tax cut will work.

The original problem was they couldnt determine exactly what FL was on the hook for so Scott filed suit to get an answer.

Now they are getting an answer.

Complicating things is the fact that UF Health and a few other hospitals rely on LIP for revenue. You just cant make a blanket decision on LIP funding without considering the aftermath.

[For_F-L-O-R-I-D-A]

Lenny Curry is using his influence in Tallahassee immediately. Huge plus of having Curry is his ability to leverage his relationships and advocate for Jacksonville:

http://m.jacksonville.com/opinion/blog/403455/tia-mitchell/2015-06-03/mayor-elect-curry-meets-legislators-about-uf-health

[Tacachale]

Curry's doing good work on this, and he's not even mayor yet. As for medicaid, I'm not sure what the Mayor-Elect of Jacksonville is going to do for that, but we'll see. Not to jump on Brown too much in his lame duck phase, but he didn't do nearly enough for UF Health when he should have.

[For_F-L-O-R-I-D-A]

Lenny Curry is using his influence in Tallahassee immediately. Huge plus of having Curry is his ability to leverage his relationships and advocate for Jacksonville:

http://m.jacksonville.com/opinion/blog/403455/tia-mitchell/2015-06-03/mayor-elect-curry-meets-legislators-about-uf-health

Meh.  He's there to try and figure out how to cut hospital funding the least in a situation where the hospital funding shouldn't be cut at all. Just expand the freaking medicaid already and stop this nonsense.

What Curry is doing is further enabling the governor he got elected to screw the poor and middle class people of this state.

Not a benefit.

And actually Brown started the conversation with the Feds.
http://www.metrojacksonville.com/article/2015-may-mayor-brown-asks-for-emergency-talk-with-burwell-

The Feds are not looking to help at this point. I liked Alvin for the most part so I have nothing against him. However, go to Tallahassee making demands on them to expand medicaid in the House and see where that gets you. He is working well for Jacksonville in the current political climate and has secured the interests of Jacksonville in this difficult budget. If you want to talk about state overall policy, that is not what Curry needs to be focused on.

I think they only way medicaid gets expanded is with the look-in to for renewal in 2 years when the Feds leave 10% of the tab on the states (which goes to 20% shortly after). Otherwise, the House and Governor won't budge. Lenny should stay out of those political weeds. Horrah for securing the funding needed for UF Health (which was the big worry on this board) and getting back to work on his transition.

[mbwright]

yeah, I might save a buck on my cable or cell bill.  Almost enough to retire comfortably.  Only problem is my health insurance might increase 10 to 30% per year, ( or a trade secret amount if you have Florida Blue).  This rate is slightly more than the cost of living.  Scott seems to think that medical costs are constant, and not a big deal.  We all pay for indigent care one way or another.  We all pay for the corporate tax cuts.  I have yet to hear how much these millions of tax saving he has proposed in the budget will put more money in my pocket, without any other cost going up.  Must be nice to live in his world.

[For_F-L-O-R-I-D-A]

http://floridapolitics.com/archives/184578-not-even-in-office-lenny-curry-secures-state-money-for-doj-cops-matching-fund

Jax's "Advocate in Chief" is back at it. Legislator connection are coming in handy fast.