Hospitals and healthcare providers in the North Country are worried about Governor Lynch's upcoming budget meeting on Friday.
They're afraid it will lead to decisions that would hurt some of the state's most vulnerable citizens.
NHPR Correspondent Chris Jensen has the story.
As if the North Country isn’t having enough trouble with plant closings.
Now some locals are worried about state budget cuts.
Gov. John Lynch has asked state agencies to come up with about $50 million in proposed cuts in order to balance the state’s budget.
Because the Department of Health and Human Services is so large it provided a list that totals close to $25 million.
“It is not a pretty set of things we were looking at.”
That’s Health and Human Services Commissioner Nick Toumpas
He met earlier this month with North Country health-care providers.
Toumpas said he hoped the cuts would not be needed and people would work together to improve efficiency.
But a few times the pep talk faltered.
“There are no silver bullets. There are not any easy answers. There is going to be pain. But I think what we’ve got to do is look for ways in which to work together and have serious dialogues.”
The concern is that healthcare providers up north are already struggling with a wide range of challenges.
The North Country Health Consortium reports the region has a larger percentage of low-income families and people without health insurance.
Steve Norton at the New Hampshire Center for Public Policy Studies says the hospitals in the North Country face tougher financial challenges.
“That means they have to shoulder an uncompensated care burden that is higher than in other parts of the state.”
There are three major sources of money for hospitals.
There is regular health insurance.
There is Medicare, which covers the elderly.
Finally, there is Medicaid.
And in New Hampshire nearly 60% of Medicaid recipients are children and the disabled.
Medicaid funding doesn’t come close to covering the cost of helping a patient with nowhere else to turn.
New Hampshire and the federal government spilt the cost of Medicaid 50/50. Whatever the state provides the feds will match. But critics say New Hampshire provides too little.
For every dollar it costs to treat a Medicaid patient, the hospital gets reimbursed about 36 cents, half of which comes from the state.
That’s according to Katie Dunn, the state’s director of the office of Medicaid
And she defends the state’s contribution.
“We actually pay very well compared to other states for services.”
But she admits that with healthcare costs steadily rising, helping the north country’s most needy residents is a pricey affair.
Few people know that better than Louise McCleery.
She’s the chief executive officer of the Upper Connecticut Valley Hospital in Colebrook.
“That is the biggest challenge there is. It is the Medicaid reimbursement and for those of us that have a higher percentage of Medicaid patients that is an extreme challenge for us.”
That low reimbursement rate is also one reason that starting in April the Weeks Medical Center in Lancaster will no longer deliver babies.
Scott Howe is the CEO at Weeks.
He says the number of births has been declining.
The hospital did about 80 last year.
Howe said that’s not enough to guarantee the practice-makes-perfect skills needed to assure top quality healthcare.
But another factor for shutting down the service was money.
“Most of our deliveries were people covered by Medicaid and the Medicaid reimbursement rates are well below what it costs to deliver the service and so for every patient we are losing a couple thousand dollars.”
That means would-be mothers will have to travel to hospitals in Berlin or perhaps Littleton.
Juggling medicine and finances and somehow trying to make do is something healthcare officials say is routine.
Warren West is the CEO of the Littleton Regional Hospital.
“I am a realist to believe that everyday I do my job today I am going to have less revenue and resources to do my job tomorrow. It is just a fact of this business. We as an organization, we as an industry have got to take advantage of anything we can to be as cost effective as we can, knowing the reality of history and the future.”
Will Medicaid cuts be one of the topics at Friday’s meeting?
Ms. Dunn, the head of the state’s Medicaid operation, says that is a very good possibility.
For NHPR News, this is Chris Jensen in Bethlehem.
