Date: 12/28/2008 12:02 AM
By The Associated Press
U.S. hospitals are beset by financial pressures from all sides. Issues cited by hospital executives, industry consultants and other experts include:
—More patients aren’t paying their bills or are taking longer to do so. Reasons include increases in people who are unemployed and have lost their health insurance, employers increasing workers’s copayments and premiums, and more people getting insurance plans that carry very high deductibles.
—More patients are putting off care until illnesses are very serious, then showing up at emergency departments, unable to pay.
—Patients are delaying diagnostic procedures and elective surgery such as joint replacements, which generally are moneymakers.
—Overall admissions are down at many hospitals, also cutting revenues.
—Government subsidies for uncompensated, or charity, care have been cut in some states due to their budget problems, and some states are starting or expected to cut reimbursements for Medicaid programs, typically one of their biggest budget items.
—Credit has become tighter, increasing borrowing costs at best and leaving hospitals unable to borrow in some cases.
—Hospital endowments and other funds invested for later use have been hurt by the stock market’s plunge, with many hospitals seeing considerable losses.
—Wealthy hospital patrons, some of whom also have suffered big investment losses, have started cutting back on donations.
—Many individual doctors and small group practices are pressuring hospitals with which they are affiliated to buy their practices because they can’t afford expensive technology upgrades, particularly computerized patient record systems.
In addition, some experts fear expected health care reforms under the new Obama administration could include cuts in the levels of Medicare and Medicaid reimbursements, a crucial issue because hospitals on average get about 55 percent of all patient revenues from those two government programs, which already don’t cover full costs of care.
Source: American Hospital Association, AP interviews.
Copyright 2008 The Associated Press.