A plan announced late last week by Gov. Tate Reeves could provide a shot in the arm to many of the state’s struggling hospitals, if it meets the approval of the federal government.
If approved, the plan’s two initiatives are estimated to generate around $700 million more for hospitals around the state, including South Sunflower County Hospital and North Sunflower Medical Center.
“The first initiative, an amendment to the existing Mississippi Hospital Access Program (MHAP), will provide direct payments to hospitals serving patients in the Mississippi Medicaid-managed care delivery system,” a release from the state’s Medicaid office said. “With these directed payments, hospitals would be reimbursed near the average commercial rate, which has been considered the federal ceiling for Medicaid reimbursements in managed care.
The second initiative will supplement Medicaid base payment rates for hospitals by reimbursing inpatient and outpatient hospital services in the fee-for-service system up to the Medicare upper payment limit. This payment mechanism, known as a UPL, is calculated similarly to the one-time emergency payment of $137 million that hospitals received through Mississippi Medicaid earlier this calendar year.”
For SSCH, that would mean an estimated additional $4.8 million per year and $2.2 million more for NSMC in Ruleville, according to calculations offered by the state.
“Additional dollars would relieve the burden of staff and supply costs, which are still inflated due to the COVID-19 pandemic,” said SSCH CEO Courtney Phillips. “We have seen a decrease in reimbursement; however, staff and supply costs remain at COVID-19 pandemic levels. With these dollars, we can purchase much-needed equipment and complete several facility repairs that we currently have on hold due to lack of funding.”
Despite skyrocketing costs and dwindling reimbursement, Sunflower County’s hospitals have found ways to see more patients and keep revenue flowing.
“The key to our success has been the overall support of the staff, board, and community,” Phillips said. “Utilization of our services allows the hospital to keep and grow service lines to provide the services our community needs. Partnerships with our vendors to share costs and grow service line volumes have worked well with our hospital. Our hospital's continuous process improvement efforts are targeted toward improving customer service and satisfaction to retain our community's utilization.”
In the meantime, Phillips said that during the pandemic, Medicaid recipients were automatically re-enrolled in the program.
Now, the recipient must re-enroll themselves every year.
“The two biggest misconceptions we have experienced with patients on Medicaid are service coverage and enrollment,” Phillips said. “Many Medicaid recipients do not know what services are covered and what services are not covered. Several Medicaid services require prior authorization, which many Medicaid recipients do not fully understand.”
