Illinois health care groups ask for Medicaid reimbursement rate … – Crain’s Chicago Business

The Illinois Health & Hospital Association, or IHA, supports Senate Bill 1763, which calls for a 20% increase to hospital Medicaid reimbursement rates. The bill, sponsored by Sens. Ann Gillespie, D-Arlington Heights, and Dave Syverson, R-Rockford, would allow every hospital in the state to collect more money from patients on Medicaid, the state-sponsored insurance plan for low-income and disabled Americans. If the bill passes, it would provide the first Medicaid base rate increase for Illinois hospitals in 28 years, according to the IHA.

Meanwhile, the Illinois Primary Health Care Association, or IPHCA, supports a similar bill, House Bill 2298, which would raise Medicaid reimbursement rates for services at Federally Qualified Health Centers. Services would include medical, dental and behavioral health care. It is estimated to cost about $50 million each for Illinois and the federal government, but the IPHCA says the rate increase would help its members care for an additional 180,000 patients each year, hire 250 more health care providers and expand services.

Both the IHA and the IPHCA say that without additional state support, hospitals and FQHCs could be forced to close units and limit services, which would reduce Illinoisans’ access to health care.

“We have felt the pressure and, candidly, the pain of a labor shortage and costs in terms of attracting and retaining and keeping positions filled in an environment where our reimbursement has not changed,” says Gerald “J.P.” Gallagher, CEO of NorthShore–Edward-Elmhurst Health and IHA board chair. “Many of our organizations, NorthShore included, were in the red last year. All of us are making difficult decisions around cost reductions and looking at more efficient ways of delivering care.”

Adding to budget pressure, particularly when it comes to Medicaid, is the fact that with the end of pandemic-era protections, Illinois, like other states, will begin kicking people off plans later this year if they no longer meet income requirements. That worries all providers, especially safety-net providers and FQHCs, because it likely means fewer patients will have insurance and be able to pay for care.

“These health centers have been historically under-resourced, and due to the demand that we see in our communities for affordable and high-quality health care, this legislation is vitally important,” state Rep. Anna Moeller, D-Elgin, a sponsor of HB 2298, said at a news conference Wednesday.

Health care providers say higher Medicaid reimbursement rates are necessary as they deal with rising costs on equipment and medications. A report from the American Hospital Association shows hospital expenses grew 17.5% between 2019 and 2022. Even more challenging is keeping up with labor costs amid a nationwide health care worker shortage that has forced providers to spend more than ever on salaries and benefits. The same AHA report documents that hospitals saw labor costs grow more than 20% from 2019 to 2022.

At NorthShore–Edward-Elmhurst, about 10% of the health system’s 27,000 positions are vacant, most of them nursing and patient care technician roles, Gallagher says.

“We can’t hire people fast enough,” Gallagher says.

The IHA met with several lawmakers on Wednesday, including Gov. J.B. Pritzker, to advocate for the Medicaid legislation, says IHA CEO A.J. Wilhelmi.

“I felt good about the conversations,” he says. “We look forward to further conversations with the Pritzker administration, the Senate, House leadership, and we are hopeful we can drive this home in the last month of session.”

Aside from Medicaid-focused legislation, the IHA is also advocating for Senate Bill 1863, sponsored by Senate Republican Leader John Curran of Lemont and Sen. Bill Cunningham, D-Chicago, which aims to levy more consequences on patients who become violent with health care workers.

“If you were in the room today, you would have heard some pretty shocking stories about violence against health care workers in our facilities,” Gallagher says. “The physical and verbal abuse of health care workers has escalated to a level none of us have seen.”

In a nationwide survey of 2,500 nurses published last year by National Nurses United, nearly half of nurses reported an increase in workplace violence, up from about 30% the year before.

In addition to voicing support for certain bills, the IHA this week also spoke out against certain legislation, including House Bill 3338, which creates the Safe Patient Limits Act. The bill calls for limiting the number of patients assigned to one nurse at any given time. The IHA opposes the legislation, saying that a “mandatory, one-size-fits all” nursing ratio is an “excessive overreach.” Instead, Wilhelmi says hospitals should be able to retain flexibility to staff their facilities as they best see fit.

“We have nursing care committees established within in our hospitals that are made up of direct care nurses that are driving the staffing models across the state of Illinois,” Wilhelmi says. “It’s reflective of the acuity of the patients on a particular day in a particular unit, as well as the experience of the nurse.”

Adding statewide staffing requirements would also be hard to meet during a labor shortage, Gallagher argues.

“Just coming up with hard-and-fast rules that are prescriptive, we don’t believe recognizes the realty of the environment that we’re in,” says Gallagher, adding that many hospitals are experimenting with team-based approaches that sometimes substitute in lower-level caregivers when possible.

However, proponents of the Safe Patient Limits Act, including nurse unions, say legislation like this makes patients safer.

Ino Saves New

via rk2’s favorite articles on Inoreader

April 21, 2023 at 06:51AM

Leave a Reply

Fill in your details below or click an icon to log in: Logo

You are commenting using your account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s