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Hennepin County officials said Thursday that a DFL-sponsored plan to charge counties extra to cover health care for their neediest residents would have an unfair impact on the state's largest county and biggest public hospital.
Struggling to figure out how to maintain a safety net in the face of massive state cuts, county commissioners were briefed by Hennepin County Medical Center (HCMC) officials on legislative proposals to partly salvage the state's health insurance program for the poorest Minnesotans, called General Assistance Medical Care (GAMC).
The $400 million program is slated to end March 1, owing to Gov. Tim Pawlenty's veto last year as part of his efforts to balance the state's budget.
Much of the discussion on Thursday revolved around steps the hospital might take to make health care delivery to GAMC participants more innovative and ultimately less expensive.
That strategy, called a coordinated care partnership network, is designed to find ways to prevent health issues so that hospitalization isn't required, or to substitute nursing services when a hospital stay isn't absolutely needed.
The state has called on hospitals to more efficiently use the resources they already have to treat the poor, and HCMC officials acknowledged that savings can be wrung out of the system by making it more flexible and drawing on other human support services.
Commissioner Peter McLaughlin wondered whether the county might be able to leverage such reform measures for a bigger chunk of state funding.
"You can't do reform on the thin gruel they're proposing to give us right now," he said.
The plan introduced last month by DFL legislators to restore most of the GAMC funding wouldn't include new taxes. Instead, it would rely on hospital and health group surcharges to build up a pool large enough to draw federal matching funds, and then return funding to the hospitals and health plans for the GAMC care they provide.
It also would require counties to contribute 10 percent of the program's cost. The 10 percent county share struck commissioners as particularly unfair to Hennepin County, given the extent to which the county subsidizes HCMC.
"I think we need to fight this notion of a county share because of its long-term implications," McLaughlin said.
The GAMC cuts would cost the hospital about $50 million. Under the DFL plan, it's estimated that HCMC would recoup about $13 million.
That amounts to a funding restoration of 26 percent for HCMC -- considerably less than the 59 percent that North Memorial Medical Center in Robbinsdale would get back under the same revenue formula. HCMC provides more uncompensated services than any other hospital in the state.
"We do need to seek equity on what's coming out of this bill," said Arthur Gonzalez, HCMC's CEO. Federal health reform offers some hope, he added, but it shouldn't be counted on just yet.
Kevin Duchschere • 612-673-4455