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Law could save hospital money
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DARLINGTON - Memorial Hospital of Lafayette County could see a reduction in profit losses from the new Critical Access Hospitals Bill (AB 770) signed into law this week by Gov. Jim Doyle, which will help leverage resources and federal funding for small rural hospitals, according to a hospital administrator.

"The bottom line is that we will just be losing less money," said Sherry Kudronowicz, administrator for Memorial Hospital of Lafayette County, Darlington.

Lafayette County is one of 59 communities served by Critical Access Hospitals (CAH). Wisconsin Department of Health defines the hospitals as rural acute care facilities with 25 or fewer beds, providing 24-hour emergency services, acute inpatient and swing-bed care. The hospitals' range of services vary according to local needs.

Kudronowicz said Memorial Hospital will lose about $50,000 less under the new bill.

Medicaid cuts in the 2009-11 state budget are stripping Memorial Hospital of $100-120,000 annually, and a 10 percent tax is costing about it $50-55,000 a year. Both took effect in January.

The new law actually creates a new tax - on CAHs' projected revenue. The tax is modeled after a similar tax placed on larger hospitals last year, from which CAHs were exempt.

The money generated by the tax is to be used to increase funding for state health programs, such as BadgerCare Plus and Medicaid, which draw matching federal dollars that pay 62 percent or more of the cost of the programs. The hospital taxes and federal matching funds are expected to increase what the state pays the hospitals for services.

Although Memorial Hospital doesn't have a lot of Medicaid patients, Kudronowicz said the numbers of Medicaid users and self-payers have been increasing as the economy worsens.

"People are falling through the cracks. They (self-payers) make too much money for eligibility, but not enough for expensive health insurance. The middle class is becoming a much poorer class," she said.

The provisions in the bill take effect July 1, with the first critical access hospital assessment payments due by Sept. 30, 2010.

"Until then, we will be paying the taxes," Kudronowicz said.

The bill appropriates $1 million annually of the projected $10.6 million annual CAH assessment revenue for health care provider loans and rural physician residency assistance.

The funds are to be used to help train additional doctors to serve in rural areas.

The bill directs $750,000 toward the University of Wisconsin School of Medicine and Public Health to create family medicine residency programs and rotations at rural hospitals to help doctors gain experience in critical access hospital settings. An additional $250,000 is set aside annually to increases the maximum amount of loan repayment, from $50,000 to $100,000, given to doctors who decide to practice in a rural area.

"I truly hope the money goes for its intended purposes, which is that (more doctors in rural areas)," Kudronowicz said. "It's a really good endorsement. Young doctors come out of med. school with a tremendous amount owned for their education."

The bill requires DHS to submit a state Medicaid plan amendment to the federal government to implement the critical access hospital assessment as provided for in the bill, and specifies that if the federal government disapproves the state plan amendment, DHS must discontinue the assessment on critical access hospitals and refund any critical access hospital assessment revenue collected in fiscal year 2010-11.

Doyle signed the Critical Access Hospitals Bill Monday morning at the Columbus Community Hospital in Columbus.

Columbus Community Hospital CEO Ed Harding chaired the Committee on Rural Health Care that brought together the Wisconsin Hospital Association and the Rural Wisconsin Health Cooperative to help develop the bill.