Newton Medical Center asks BOC for millage rate increase

NMC: Indigent care costs climbing

COVINGTON — Officials at Newton Medical Center have requested a slight increase in the county’s millage rate to help cover the rising costs of indigent care.

Hospital CEO Jim Weadick and Troy Brooks, assistant administrator of fiscal services, made a presentation Tuesday during the Board of Commissioners work session requesting that the current appropriation of 1.2 mills be increased to 1.5 mills.

Newton County delineates a specific millage rate to Newton Medical Center for indigent care that has been set at 1.2 mills for the past several years.

“It’s extremely unusual for us to have on the tax bill itself a separate millage rate for the hospital,” said Commission Chairman Keith Ellis. “When we did it years ago, it was a great idea, but it is unusual.”

Brooks said that the recession has negatively impacted the value of a mill — resulting in a de facto reduction in revenue — while the demand for services at the hospital continues to climb.

“The value of a mill in the county has been sliding significantly since 2008 when it peaked, so as we have been assigned the same millage rate of 1.2 in each of the succeeding years, the support for indigent care continues to dwindle away,” he said.

Brooks said that in actual dollars, the amount received from the county for indigent care dropped by $1.3 million between 2008 and 2013.

“We are asking the commissioners to up the millage value to maybe get us back to where we are tracking with the growing demand,” he said.

Brooks said that the additional .3 mill would bring in about $590,000.

“That would be a huge help to us,” he said.

In addition to an increase in demand in the emergency room and other services, Brooks said the federal Affordable Care Act is also having an effect on the hospital’s bottom line.

“I’m not sure of all the ways it is impacting us,” he said. “I can tell you we have seen changes in our volume that occurred on Jan. 1 that I have never seen in the 27 years I have been here, but I don’t know if it has everything to do with Obamacare or not.”

He did point out a couple of areas that he does relate to the new health care law. One, he said, is that he believes some people are getting into insurance plans with high deductibles that may be keeping them from pursuing health care services, especially elective services, as long as they can.

Brooks said that people enrolled in some plans can only go to certain hospitals or see particular doctors.

“There is a lot of confusion about where to go and get health care,” he said.

The second way the Affordable Care Act is impacting the hospital is in the area of Medicare reimbursements.

Brooks said it was his understanding that under the new health care law, federal Medicare reimbursements would decline, but states would be given support for a few years to expand their Medicaid programs.

“To my understanding, it was designed as a trade-off of sorts,” he said.

However, Georgia, like several other states, has declined to expand Medicaid, creating a perfect storm, Brooks said.

“So we’re seeing Medicare decrease and we’re not getting an increase in Medicaid,” he said.

Brooks said that hospital administrators sent in a request several months ago to commissioners when they were beginning the budgeting process and said he was grateful to have an opportunity to speak before the full board on Tuesday to explain why an increase would be necessary.

Ellis said the BOC invited Weadick and Brooks to make a presentation so that they could explain to the full board what their challenges and needs are.

“We are pleased they were willing to come to us and we welcome them in front of the Board of Commissioners as frequently as they want to be there,” Ellis said. “We stand ready to meet with them at any point over the next year.”

Ellis said it is unlikely that the increase would pass this year since the BOC is poised to adopt its fiscal year 2015 budget today at 7 p.m., following a public hearing on setting the millage rate at 11.225.

He said that if any changes were made, it would require re-advertising the new millage rate, delaying its adoption.

“I don’t believe the board is interested in going up more this year, but next year, due to the fact that they came to us this year, if their financial situation does not change, we may elect to change the millage number,” Ellis said.

Brooks said Newton Medical Center is an “institution that physically is still in excellent shape with great clinical programs.

“Financially, the last four years have been a challenge,” he said. “It’s a challenge we face every day or week to find the best way to ensure our long-term well-being. Our approach to the county commissioners is part of that effort. It’s our intention to see Newton Medical Center is here for another 60 years.”