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WASHINGTON HOSPITAL THREATENS TO AXE
TRICARE -- "TRICARE must increase reimbursement
if the hospital is to continue to provide
services to
the military and dependent populations."
More doctors and hospitals are dropping out of
TRICARE, or threatening to, as they find that the reimbursement levels
are not adequate.
For more on TRICARE, use the VA Watchdog search
engine...click here...
http://www.yourvabenefits.org/ses
search.php?q=tricare&op=and
Story here...
http://www.whidbeynews
times.com/portals-code/list.cgi?pap
er=84&cat=23&id=1044822&more=0
Story below:
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Hospital threatens to axe Tricare
By Paul Boring
Members of the military and their dependents may some day find their
health insurance is not accepted at Whidbey General Hospital.
A strongly-worded letter from the Whidbey General Hospital
administration to Tricare will place the proverbial ball in the military
health care provider’s court.
Reimbursements well below hospital costs from Tricare, the Department of
Defense’s health care program for members of the uniformed services,
their families and survivors, has backed the hospital into a financial
corner.
Meetings with Tricare representatives have thus far bore no fruit,
prompting the drafting and subsequent mailing of the letter, which was
approved by the hospital board Monday night.
“They recognize the problem,” said Scott Rhine, hospital chief executive
officer, at the meeting. “The question remains what means they have to
address it.”
Whidbey General became a “critical access hospital” at the end of 2005
in order to increase government-sponsored reimbursements. The
designation was designed specifically to provide cost-based
reimbursement for Medicare patients in smaller, rural hospitals.
The other major government payer on Whidbey is Tricare. If the military
provider’s reimbursement methodology is not changed to reflect the
hospital’s status, the contract will be terminated.
“Because of the large number of Tricare patients seen, relative to our
small patient base, Tricare must increase reimbursement if the hospital
is to continue to provide services to the military and dependent
populations,” the letter reads. “Please believe we want to be supportive
of our military forces and their families. We appreciate their service
to our country and to our community. At the same time, we cannot afford
to jeopardize health care services to other residents of Whidbey
Island.”
Doug Bishop, Whidbey General’s chief financial officer, said Tricare
reimburses the hospital only 39 cents for every dollar, compared to
Medicaid’s 56 cents. And to exacerbate the problem, 7 percent of the
hospital’s business is accounted for by military patients using Tricare.
“That’s a sizable chunk to be hit with,” Bishop said.
The letter was crafted to convey the gravity of the situation without
formally canceling the contract, Rhine told the board.
“We need to let them know that it is a concern to the hospital and to
our long-term viability,” he said.
Chief of Staff Dr. Chris Bibby said the changes to allow higher
reimbursements will ultimately have to be made by Congress, a task he
likened to moving a buffalo by pulling its tail.
The hospital administration will wait for a response to the letter
before taking any direct action. Rhine said 60 days is generally the
amount of time alloted for a reply.
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Larry Scott --
