PORT ANGELES — Getting the uninsured to sign up for Medicaid will be “critical” for Olympic Medical Center to withstand cuts to Medicare reimbursement, the hospital’s chief executive said this week.
OMC is one of several organizations that will help Clallam County’s 11,000 uninsured residents sign up for Medicaid or find a private insurer through a state-based exchange under the Affordable Care Act.
The 2010 law, also known as “Obamacare,” expands access to health care by broadening Medicaid eligibility and health insurance exchanges but cuts Medicare reimbursements to hospitals to pay for it.
Medicare is a federal health insurance program for people older than 65, while Medicaid is a state-managed federal health insurance program for low-income families and individuals of all ages.
The cuts are “dramatic” for a Medicare-dependent hospital such as OMC, which gets 57 percent of its revenue from the program, CEO Eric Lewis told hospital commissioners at their Wednesday board meeting.
OMC faces a $1.6 million cut from the Affordable Care Act and another $1.6 million cut from federal budget sequestration and “fiscal cliff” negotiations.
Lewis warned that more cuts may be on the horizon.
“In 2014, I think we have to get people signed up as quickly as possible to make up for these Medicare cuts,” he said.
Although OMC is paid just 60 percent of cost to treat a Medicaid patient, insuring the uninsured will reduce uncompensated care, which topped $10 million in 2012.
Lower bad debt cost
“If we get people signed up, our bad debts . . . could plummet,” Lewis said.
“If that happens, it’s going to balance our budget with all these cuts that are coming in Medicare. We’re certainly not going to get rich, but I’m hoping we can balance our budget. That’s got to be our goal.”
The state selected Choice Regional Health Network of Olympia to be Clallam, Jefferson and five other counties’ lead organization on the exchange.
Choice Regional Health approved OMC, Volunteers in Medicine of the Olympics, Olympic Area Agency on Aging, Planned Parenthood and Forks Community Hospital to be the “in-person assistance network partners” in Clallam County.
In Jefferson County, the public health department also has been approved.
OMC will train 21 employees this month to help people find a plan that works for them.
Open enrollment begins Oct. 1, with coverage beginning Jan. 1.
For information on the exchange, visit www.wahealthplanfinder.org.
Affordable Care Act
Lewis covered regulatory requirements, home health cuts and other impacts of the Affordable Care Act in a wide-ranging briefing on health care reform.
“Everybody in the organization is feeling these changes,” he said.
“We used to do 10-year plans in health care, 10-year financial projections. Right now, it’s hard to do one for the next 12 months. That’s just the environment we’re in.”
In board action, commissioners approved a $345,000 agreement with Swedish Medical Center, OMC’s affiliate, to recruit another cardiologist.
The doctor will be a Swedish employee who lives and works in Clallam County and is a full member of Olympic Medical Physicians.
The pact was based on earlier recruitment agreements that brought neurologist Dr. Stafford Conway and sleep physician Dr. Michael McDonald to the North Olympic Peninsula.
“We feel that this [cardiologist] position is critical to get started on very soon so that we can further enhance our access of patients to our heart program,” said Dr. Rebecca Corley, chief physician officer.
“And this will also just further strengthen our affiliation with Swedish, really with an eye on quality and service to our community.”
Commissioners also approved a $410,180-per-year professional services agreement with orthopedic surgeon Dr. Henry Yee, who provides 24-hour on-call coverage for the hospital’s Level 3 trauma center two weeks out of the month.
Level 3 status means OMC has surgeons available within 30 minutes at all hours, every day.
The next closest Level 3 trauma center is Harrison Medical Center in Bremerton.
“You don’t want to need that general surgeon or orthopedic surgeon at 2 in the morning, but if you do, it’s critical,” Lewis said.
“It’s an asset for this community to have a Level 3 trauma center, and Dr. Yee is part of the team.”
Program re-accredited
Earlier in the meeting, Dr. Scott Kennedy, chief medical officer, announced that OMC’s cancer program was re-accredited by the American College of Surgeons’ Commission on Cancer and “passed with flying colors,” with six of eight possible commendations.
OMC’s cancer center, which also is accredited by the American College of Radiology, is one of the few cancer centers in the state to boast multiple accreditations.
It has a long-standing affiliation with the Seattle Cancer Care Alliance.
“We’ve just got a first-class outfit over there, I mean really a first-class outfit,” Commissioner Jim Leskinovitch said.
“I just wish our community really would understand that better than they do. It’s high time.”
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Reporter Rob Ollikainen can be reached at 360-452-2345, ext. 5072, or at rollikainen@peninsuladailynews.com.