2010 January 19

Main Street Journal: Opinion Editorial: What to do with The MED

The Main Street Journal Website

The following article is taken from the January 2010 issue of the Main Street Journal. Click “Subscribe Online” above to start your subscription.

What to do with The MED
By: Shelby County Commissioner Mike Ritz

The MED, Shelby County’s trauma hospital, burn and wound center, and neonatal /early childbirth care center suffers multiple financial challenges. Clearly related to the expert care available at The MED is the fact that The MED is the principal teaching hospital for UTCHS.

Most of The MED’s care is paid for by TENNcare. The Med receives about $33 million in supplemental payments thru the state of Tennessee and about $27 million annually from Shelby County. Much is made about the care given Arkansas and Mississippi residents for which The MED is uncompensated and which care, by federal law, cannot be denied based on the patient’s residency. In the $350 million annual budget of The MED, that uncompensated out-of-sate care cost approximately $25 million. I consider what our neighboring states owe us as the last two ornaments on a Christmas tree.

Year in and year out, the State of Tennessee has collected funds from the federal government for uncompensated care at the State’s 22 public care hospitals. The MED is by far the largest care provider and has the largest amount of uncompensated care. For the latest fiscal year of The MED, Tennessee collected about $85 million for uncompensated care at the MED but sent the MED only $33 million. The federal rules allow the state governors s to reimburse the public care hospitals as they see fit. Governor Bredesen and prior Tennessee governors have used the extra money ($53 million last year) to finance TENNcare and other needs of the state. Their excuse is the state needs to use our money to fund TENNcare and that the TENNcare does pay for a lot of MED patient expenses. If the State would give us just 2/3 of what they collect from the feds on our billings, we would not have the financial crises we now have at the MED. If we were to get 100%l of the MED billings reimbursed by the feds, we would have the funds to pay for the debt service on a new public hospital. It is not fair to ask Shelby County taxpayers to pay for what the State is doing to the MED.

I do not see a political solution to this problem. I do not see this governor or any other governor alienating the legislators from outside Shelby by taking other monies to do what is right at The MED. I do see a civil rights/equal protection argument being made in a lawsuit filed on The MED’s behalf in US District Court causing the state to correct their long term misuse of The MED’s billing to fund care outside of Big Shelby.

Another potential big financial assist could be made with a tax or fee on the billings or beds at the private care hospitals in Shelby County. Reportedly the state could earn even more federal money on this tax/fee which could be used to fund uncompensated care at the MED. There is a current rumor that the Tennessee Hospital Association may propose such a fee or tax state wide because of the threats by Governor Bredesen to cut TENNcare due to the state‘s fiscal problems. It would be bittersweet to get such a tax or fee Shelby County wide or statewide and still see the MED not get the funds the Governor keeps from our uncompensated care funded by the feds.

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