Medical Center adjusting to new tax, laws

Photo by Howard Reed

Photo by Howard Reed

CONYERS -- Rockdale Medical Center is adjusting to a new tax imposed in 2010, while at the same time waiting to see what the new federal health care law will mean in 2011.

RMC's chief financial officer Sandy Albrecht recently told the Citizen that the state-mandated hospital tax went into effect July 1. The 1.45 percent tax is on net patient revenues and was imposed by Georgia legislation to help fill a projected $600 million shortfall in serving Medicaid patients. Medicaid is a state and federally funded program that provides health care for those who cannot pay.

Albrecht said the hospital has already made its quarterly tax payment and will receive a 11.88 percent increase in state reimbursements for serving Medicaid patients, as outlined in HB 307. Those reimbursements are made on a claim-by-claim basis and the amount of those reimbursements depends on the patient's condition and length of hospital stay. On average, RMC is reimbursed 20 cents on the dollar for every Medicaid patient, according to Albrecht. But she could not say how much money in reimbursements the hospital will receive and how it compares to the hospital tax payments. There is some lag time between the tax payment and the reimbursement.

"We're still kind of in a 'Let's look and let's see and let's gather more information as claims are being paid,'" Albrecht said.

The intent behind the tax was that it would not be a burden on hospitals, according to Albrecht. But the tax is not really "a plus" for the hospital unless reimbursements make it budget-neutral.

For now, the hospital will continue to serve its patients as it always has.

"We really haven't changed our scope or services or our day-to-day dealing with patients as a result of this tax," Albrecht said. "The hospital has an established indigent and charity program for those who can not pay ... If a person is in emergency situation, we provide the care -- no questions asked about payer source or ability to pay."

To make up for their lost dollars, there are state and federal reimbursement programs, like the Disproportionate Share Hospital program (DSH).

"The reality is the dollars don't really come close to matching the free care that we give," Albrecht said of the programs. "We have seen a significant increase in uncompensated care or indigent charity care."

That increase came out to be a 309 percent from 2008 through 2010.

She hopes that health care reform will address the issues in servicing the uninsured and underinsured. But there is still a lot of uncertainty on what the new health law would mean for RMC.

"This is major legislation -- volumes of information. Most all of it is phased in over time," Albrecht said.

Albrecht said RMC has not currently seen any significant changes and has not done anything different.

"But it is the basic premise of the law that over time we will see patients that have insurance that will cover these costs," Albrecht said.

The hospital will continue to manage its cash flow and expenses and "rather than cut, we're looking for growth," Albrecht said.

She explained that the hospital is looking for ways to increase services and attract more patients, such as through a focus on physician recruitment, women's services and encouraging more preventative health measures. RMC will open its outpatient imaging center in the spring.

"We want to have patients leave here satisfied with the quality of care and quality of service they receive here," Albrecht said.