State hospitals’ CEO talks health care issues

John Matessino, CEO of the Louisiana Hospital Association and self-described ‘card-carrying lobbyist, rehashed the severity of the issues that shroud the state and national health care systems and lamented a problematic future last week.

Nearly 2 million Louisiana residents would be enrolled in the state and federally funded Medicaid program by 2014, Matessino said. He said the current number hovers around 1.3 million people, and the jump would be facilitated by decreased eligibility requirements and a realization of need.

‘When we reach this point, somewhere between 42 and 47 percent of the entire population of the state of Louisiana will qualify for Medicaid, Matessino said. ‘Think about that. That gives me heartburn. That’s our tax dollars, folks.

Medicaid eligibility would be at 133 percent of the federal poverty line in 2014, per national health care legislation. Matessino said this would make an additional 260,000 Louisiana residents eligible.

He also said approximately 260,000 state citizens are currently eligible for the state taxpayer-funded insurance, but they haven’t enrolled because they haven’t needed it.

The increase in Medicaid enrollment is particularly troublesome from the hospitals’ perspective because reimbursement ration is about 60 percent of service costs, Matessino said. He stressed that ratio is the percentage of cost and does not factor in an expected profit margin.

‘We have been faced with cuts and cuts and cuts to Medicaid for the last 26 or 27 months, Matessino said. ‘They are paying us much less now than they were in 1994. It’s because they keep adding more and more people to the roll.

‘Right now, you heard me say Medicare pays about 90 percent; Medicaid is paying about 60 percent of the costs. You and I, with our health insurance are paying about 130 percent of the costs. We’re making up for what the government programs aren’t paying for.

Jacob Giardina, chairman of the Thibodaux Regional Medical Center Board of Commissioners, agreed with that sentiment after the presentation.

‘It’s a tax because people with health insurance are subsidizing it, he said.

Matessino praised Thibodaux Regional Medical Center for being able to complete a $100 million expansion and renovation project without having to take on debt. ‘Zero long-term debt. I’ve got to tell you, I don’t know another hospital in the state of Louisiana like that. Not one, he said as those in the room applauded the award-winning hospital.

Greg Stock, CEO of TRMC, said the cuts to Medicaid reimbursement have not impacted his hospital as dramatically as others. ‘We’ve been able to close that [reimbursement versus cost] gap more than most through efficiency and productivity.

It has been a contentious legislative session and nerve-wracking for health care and higher education stakeholders in Baton Rouge as the state’s lawmakers try to cut $1.6 billion out of $2.6 billion in discretionary general funds.

About $81 million in health care funds had been cut, Matessino said, but ‘many of the cuts have been restored.

‘I think that sometimes, it’s an election year, and so people want to go back and say I cut taxes, and I’ve done all these things, and in the end, we’re kind of getting left holding the bag on the health care side. They’ve passed some things in the house not knowing or thinking that it’s going to cut health care

The higher education sector represents an unintentional, unwanted opponent to the state’s health care industry because the two make up the bulk of the $2.6 billion in slash-able funds. Matessino said it has been ‘dog-eat-dog.

All the while, the national health care reform legislation, often labeled ‘Obamacare, hangs in the balance and offers more uncertainty than predictability. The LHA CEO said that although he ‘loves that everyone’s covered, in what he described as a rationing of health insurance, he’s ‘not real confident in the program. He said his chief concern is a ‘lack of bipartisan discussion.

Matessino addressed members of Thibodaux’s Chamber of Commerce at the Western Sizzlin last Thursday.