Since Arizona will not be managing a health insurance exchange mandated by the federal government, rural hospitals worry about their futures. Concerns run high that reimbursement, or the money that they get from insurance companies for caring for those patients, will drop under federal oversight.
"I've had my bottom line halved to what it was a year ago," said Jim Dickson, CEO of Copper Queen Community Hospital in Bisbee. "And so, what you're seeing is a diminishment in the capacity of hospitals to provide care. And if this keeps going the way it's going, you're going to have closures."
He said that two out of every three patients at the hospital use Medicare or Medicaid, which do not pay enough to cover the costs of a patient's visit. He said that a federally-managed healthcare exchange will only mean more patients with plans that don't cover costs coming to rural hospitals with small profit margins and little room for loss.
"We're probably one of the lowest cost hospitals in Arizona," Dickson said. "But the fact is, it's starting to bump on me now and some of the other hospitals really are just not in good shape."
Dickson said that he would rather that the state manage our health insurance exchange, and here's why: better access to lawmakers. Telemedicine basically allows doctors, nurses and others to direct care over the phone or Internet, which can save millions of dollars in transportation. He said that the state understands that more than the feds, all while up to a half a million Arizonans could get covered by an exchange.
"This hospital pioneered telemedicine," Dickson said. "We saved about $1.5 million in transfer costs by having telecardiology. So we're saving money. But we're not seeing the insurance companies recognize that and so if we could have put that through the exchanges that they had to cover telemedicine, state or locally controlled, that would have insured, we would have gotten paid for this."
Dickson also worried about the timeline for the exchange: the beginning of 2014. He compared it to starting Medicare in one year.
But he said that the governor made the right move by leaving the exchanges to the federal government. If problems begin in a few years with health insurance not covering enough costs, the federal government will have to deal with the problem.
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