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Kentucky Hospitals Say They Will Lose $1 Billion Due to State’s Obamacare Exchange

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posted on Jun, 10 2015 @ 09:49 AM
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originally posted by: SlapMonkey
a reply to: Sremmos80

I must ask...did you read the actual report from the Kentucky Hospital Board, or did you just knee-jerk react to seeing the word "Breitbart" and immediately search for a counter article?

This is why I posted the original white paper, so that we could all read it and come to our own conclusions, not just cite an Obamacare- or Republican-bashing article and take it as fact.

We all know that hospitals do unnecessary procedures and do some shady things, but citing one hospital does not indicate all hospitals do that in KY. Same goes for the few noting record bottom lines (which still don't mean that they were good bottom lines). Sure, slowing down on spending for hospital care would be a good thing for individuals, but you do that by bettering your own health, not by refusing to pay for care or firing people to lower hospital costs.

I'll give you this...your source was less biased, but certainly not unbiased in the other direction. And you're side-stepping one of the main points: This legislation was claimed to be some miraculous thing for healthcare and individuals alike. Reality is reflecting a different image.



Dr's are a bit underpaid due to the responsibility and liability they carry, IMHO (but I'm biased).

There are a lot less "unnecessary" procedures done than the government claims. When the RAC audits they frequently claim something as unnecessary due to errors in coding and documentation. An 8 number code could be one number off or the codes are in the improper order or the right exact phrase that they are looking for could be in the wrong place or not worded correctly and they call those "unnecessary" and fine the hospital or clinic even when medically the procedures were perfectly appropriate.

Do not be fooled about all of the claims of medicare fraud--it is a regulatory shell game and the government under Obama has hired corporations to audit healthcare providers and their pay is 12.5% of the fines they can levy and the money they can "recover" so the corporation is not interested in truth nor fairness.

It is part of Cloward-Pivven. Make the cost of doing business so high and so troublesome that we'll beg for government takeover.




posted on Jun, 10 2015 @ 12:53 PM
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Although this article isn't about Kentucky and is more of a look in the past, I can't help but wonder it really isn't pointing to the main problem of the healthcare system in this country.

The hidden health tax that brought down a speaker
www.capitalnewyork.com...

Some here say that it's the cost of treating those that are unable/unwilling to pay but if you read that article you will notice that close to $800 million is given by the state to help in this area. It's just that there is no rhyme or reason behind who gets the money!!

All in all I think the point that I am making is that our gov't is great at driving the cost of healthcare up through the roof, it provides a need that they can step in to fix by way of our taxes, once they get their hands on our tax money though, more often than not, it disappears, in NY's case, becomes untracable and well god only knows where it goes to.

we either need honest politicains or the gov't just stepping back and quit playing the middleman! they are only doing it for their own profit!



posted on Jun, 10 2015 @ 12:56 PM
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originally posted by: dawnstar
Some here say that it's the cost of treating those that are unable/unwilling to pay but if you read that article you will notice that close to $800 million is given by the state to help in this area. It's just that there is no rhyme or reason behind who gets the money!!

When inflation is taken into account, that amount, is significantly less than they were getting previously and is now affecting profits and in the case of the non-profit hospitals, it has the potential to lower executive compensation, hence the bellyaching.

Please reread my previous comment. Here is a link to a publication from the state of Kentucky confirming my earlier statement:

In 2006 , inpatient and out patient Medicaid payments to hospitals were $ 992 million and by 2009 they were $1.34 billion . That growth occurred more quickly in Urban Hospitals, which experienced 38% payment growth over that time period. Rural hospitals experienced 28% growth over the same period.

As a result of Medicaid expansion, more Kentuckians are insured now than ever before, and providers are beginning to receive substantial payments for individuals who would have previously gone untreated or been unable to pay for their care.

Hospitals are beginning to see their share of uncompensated visits significantly drop as Medicaid begins to reimburse for the
previously uninsured. Data submitted to the Cabinet for Health and Family Services by the Kentucky Hospital Association (KHA) has shown that hospitals experienced a 60% reduction in the types of claims that result in uncompensated care when comparing the first three quarters of 2013 to the same time period in 2014.


Face the facts, the guys running these hospitals in Kentucky based thier long term business plans on government reimbursement and got caught with their pants down when it was reduced. I don't have a lick of sympathy for them, they should be fired and the hospitals sold to the highest bidder.

Also, no specific hospital or health system is named in the article, so I can't look up the financials of the hospitals that are doing the complaining. Did they borrow money to build new hospital buildings during the previous presidential administration, expecting the reimbursement gravy train to keep rolling, but now that its over, can't make their loan payments? Or did they choose to not move outpatient services to less expensive locations because they could charge more for services housed inside the hospital?

No way to tell, but in my experience these kinds of reasons are nearly always the case.
edit on 10-6-2015 by boohoo because: (no reason given)



posted on Jun, 10 2015 @ 01:21 PM
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a reply to: Krazysh0t

I'm just happy to agree on something for once with you



posted on Jun, 10 2015 @ 01:25 PM
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originally posted by: dawnstarwe either need honest politicains or the gov't just stepping back and quit playing the middleman! they are only doing it for their own profit!


Agreed. You want to start holding your breath first, or shall I?



posted on Jun, 10 2015 @ 01:39 PM
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a reply to: boohoo

The guys running these hospitals are basically at the mercy of Gov. Beshear and his decision to expand Medicaid in the state with only a limited amount of what amounts to a temporary lump sum of federal assistance--all based on pressure from the federal government. Once that sum of federal monies runs out, the state is left to pick up the tab of this expanded Medicaid--Kentucky isn't exactly rolling in the dough as far as net income per capita is concerned. Can you tell me from what source that this money will magically appear?

So, how is it that your conclusion is that it's the fault of the administrators of the hospitals? EVERY time a company, industry, organization or individual does something that relies on federal dollars, they are always caught with their pants down. I'm amazed that there has not been a harsh lesson learned yet.

Stop getting into bed with the government, industry!!!



posted on Jun, 10 2015 @ 02:18 PM
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a reply to: SlapMonkey

the people running the hospitals were initially, probably drooling at the idea of the increase in paying patients, who cares if it was gov't money or not. it wasn't till the devil hiding in the details revealed themselves that they started feeling sick. over the decades we've somehow managed to build a healthcare system that not very many people can afford, businesses' healthcare plans were getting to the point where they couldn't afford them, and well, our gov't has been struggling trying to justify taxing the people for it! ya it's state of the art, best in the world, maybe....but what good is it if the cost is so unaffordable that only the rich can afford it? and considering that every taxpayer has contributed to building it, as well as helping the poor pay for it, well is it really fair to allow it to come to the point where only a small percentage of the population can afford it?



Money from the fund is poured into the state’s budget to fund Medicaid, triggering 50 percent federal matching funds that are essential to fund the massive $54 billion program that now provides insurance for nearly a third of all New Yorkers.
www.abovetopsecret.com...


and well they are allocating 800 million for the next 5 years to help offset the cost of providing care for the uninsured. so just how many are unable to pay the healthcare costs in just NY really?? How many of those are contributing to that tax pool that is generating billions of dollars in revenue with the expressed purpose to make healthcare affordable in just NY?

So the poor healthcare providers need to tighten their belts, who the heck isn't finding that they have to?? what we needed was a valid plan to cut the healthcare costs, instead what we got was a so, you can't afford it, but it anyways deal which isn't going to work because WE CAN'T REALLY AFFORD IT!



posted on Jun, 10 2015 @ 02:22 PM
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originally posted by: Krazysh0t
a reply to: SlapMonkey

This stupid mess will never be fixed until we stop catering to the insurance companies like they are NECESSARY for the health care industry to thrive. Once we stop doing that, watch health care costs plummet back to respectable levels overnight.


even a lot of us left of center guys agree on that one. the amount of wealth accumulated off the backs of sick people in this country is unpresedented



posted on Jun, 10 2015 @ 02:33 PM
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So a hospital charges $1.50 for a $ 1.5 cent Tylenol. So the $1 billion they say they'll lose is more like $10 mil.

"Charging $1.50 for a 1.5 cent generic Tylenol

I won’t quote Brill’s article at length, go read it. It’s unfuriating. He goes through the detailed hospital bills, line by line, or 7 different patients, in order to explore not only how much hospitals rip people off by charging patients $1.50 for a single generic Tylenol that costs 1.5 cents if you or I go buy it at a store. The hospital, buying such huge quantities, can surely get a much better price than that."
americablog.com...


edit on 10-6-2015 by UnBreakable because: (no reason given)

edit on 10-6-2015 by UnBreakable because: (no reason given)

edit on 10-6-2015 by UnBreakable because: (no reason given)



posted on Jun, 10 2015 @ 02:42 PM
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originally posted by: dawnstar
a reply to: SlapMonkey

the people running the hospitals were initially, probably drooling at the idea of the increase in paying patients, who cares if it was gov't money or not. it wasn't till the devil hiding in the details revealed themselves that they started feeling sick.


Much like the apathetic American public who all initially were salivating over the lies being sold about the ACA to begin with--hell, even the name is a lie: the Patient Protection and Affordable Care Act.

Yeah, my bedonkadonk!


and well they are allocating 800 million for the next 5 years to help offset the cost of providing care for the uninsured. so just how many are unable to pay the healthcare costs in just NY really?? How many of those are contributing to that tax pool that is generating billions of dollars in revenue with the expressed purpose to make healthcare affordable in just NY?


If you meant KY and not NY, the numbers are contained within the white paper to which I linked in the original OP.


So the poor healthcare providers need to tighten their belts, who the heck isn't finding that they have to?? what we needed was a valid plan to cut the healthcare costs, instead what we got was a so, you can't afford it, but it anyways deal which isn't going to work because WE CAN'T REALLY AFFORD IT!


While I want to agree with this, the reality is that many Americans--not just the wealthy and the poor on "free" or subsidized care--can afford coverage. But the truth is that hospitals do need to tighten their belts, but that can't always happen in private business and we still expect them to run. At some point--unlike the federal government's right to take my money via taxes--private companies will go bankrupt. We (as a society) can't afford for that to happen to hospitals, but I can't shake the feeling that this exact outcome is the long-term plan that the federal government has implemented with the PPACA.

Maybe that's just conspiracy talking, but math doesn't lie.



posted on Jun, 10 2015 @ 03:24 PM
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originally posted by: SlapMonkey
So, how is it that your conclusion is that it's the fault of the administrators of the hospitals? EVERY time a company, industry, organization or individual does something that relies on federal dollars, they are always caught with their pants down. I'm amazed that there has not been a harsh lesson learned yet.


Nope, you don't know the healthcare business. These were not "government contract dollars" like the type that Boeing pursues. These hospitals are at the mercy of their own projections, they do not need to base any of their numbers on government reimbursements, if they don't want to. But these guys in Kentucky did, obviously, at their own peril.

There are quite a few other national healthcare provider networks that planned for the reimbursement reduction as well. Ask Kaiser Permanente how they dealt with the EXACT same scenario versus these other hospitals in Kentucky. Kaiser knew reimbursements would not last forever, anticipated Obamacare costs and are doing quite well, post Obamacare. I GUARANTEE you that Kaiser will buy a couple of these hospitals for very cheap, when they are on the verge of bankruptcy and resident doctors are taking their practices elsewhere, exiting for greener pastures. After being bought, these hospital buildings will then restructure staffing per the Kaiser model, making them solvent again.

There is something else that you couldn't possibly consider because you aren't in the business, healthcare operators have mandatory equipment and building upgrades to maintain their acute care license. These costs have increased at the same rate they always have, BUT when you buy and operate a hospital, it should come as NO SURPRISE that you will need to spend that money to stay open as an acute care hospital. I would bet my house that a majority of these hospital operators are now nearing the deadline for some of these mandatory upgrades and are trying to find any way to pass the cost onto someone else. In fact, I would also argue that that short term thinking by being done these hospital owners in Kentucky plays into the hands of foreign investors, whom are waiting in the wings to siphon more money out of the country, primarily from poor Americans. These guys should be tarred and feathered for selling regular people out to foreign investors in this manner.

Here is a little insight into how Kaiser works:
Under our fragmented, dysfunctional system of financing health care, it is only natural that Kaiser would adjust its patient enrollment to fit its business model rather than adjust its business model to better accommodate patients.

Give it up, you simply don't know much on this particular subject, but thats OK, just be a man and admit it.
edit on 10-6-2015 by boohoo because: (no reason given)



posted on Jun, 10 2015 @ 03:46 PM
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the numbers came from the article I posted about ny...sorry, I haven't experienced kentucky's healthcare system, but I have NY.. at least to an extent..
affording insurance coverage isn't the same as affording healthcare.. one can find themselves penniless trying to get healthcare even with the insurance.
it takes just one carrier of antibiotic tb, or ebola or whatever to cause a massive pandemic though doesn't it? If that one person happens to get sick and avoids, or is turned away from the healthcare he needs because of finances isn't the outcome just as bad regardless of weather the hospitals are there or not?
and the conspiracy was there long before the obamacare came into play, the obamacare is just them trying to come up with a solution to the problems their conspiring created, not with just healthcare but the entire economy.
Anyone with a half a brain who actually took the time to see what was going on 20 or so years ago would have known that the outcome would be something like what we have today, they didn't care, or were too busy, or were just making too much danged money to care. There's been one constant from the 90's into the 2000's to the present and that is I cannot afford the healthcare. went from working productive citizen to undocumented disabled housewife, to well, now I have no idea how I am supposed to live so guess what...
Let the danged hospitals fall won't matter much at all to me. All we were ever to them was a tap that they kept turning higher and higher draining more and more in taxes to support the ruse but then when when ever we did need some help it was oh well sorry, next!!
so well oh well sorry!



posted on Jun, 10 2015 @ 06:33 PM
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a reply to: boohoo

Not one thing that you said negates the fact the the governments hand in this is a major player in why this is happening, even granting you the mismanagement issues that I've never argued aren't there.

I never claimed to be an expert, but what I am doing is using the original white paper and the information contained within to come to my conclusions—what you're doing is providing conjecture and unproven reasons to, for some reason, argue that the ACA is not an issue.

This isn't about 'being a man' or not—if you can provide proof for your speculation and conjecture about KY's hospitals, please do, but links to an organization whose goal is advocating for a single-payer national health system doesn't really make me feel better about your knowledge being unbiased.



posted on Jun, 10 2015 @ 06:53 PM
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originally posted by: SlapMonkey
I never claimed to be an expert, but what I am doing is using the original white paper and the information contained within to come to my conclusions—what you're doing is providing conjecture and unproven reasons to, for some reason, argue that the ACA is not an issue.

This isn't about 'being a man' or not—if you can provide proof for your speculation and conjecture about KY's hospitals, please do, but links to an organization whose goal is advocating for a single-payer national health system doesn't really make me feel better about your knowledge being unbiased.


My information isn't conjecture, anyone who's spent some time doing high end healthcare construction can confirm everything I've said. You not "being in the know" isn't my problem. Did you even look at the "cited sources" in the white paper you posted? They are worthless, but people without an academic background can't tell the difference. Frankly, it reads like a press release.

I've outlined whats happening here, you can choose to stick your head in the sand and pout about ACA all you like. Believe it or not, you certainly learned something new about the healthcare business by reading my posts and can now move forward more informed about the subject. I'm not a supporter of ACA, but its not the cause of these hospitals bad business decisions, they had plenty of time to adapt to the changing insurance business climate, as their competitors successfully did, ala Kaiser and Providence.
edit on 10-6-2015 by boohoo because: (no reason given)



posted on Jun, 10 2015 @ 07:03 PM
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originally posted by: boohoo

originally posted by: SlapMonkey
I never claimed to be an expert, but what I am doing is using the original white paper and the information contained within to come to my conclusions—what you're doing is providing conjecture and unproven reasons to, for some reason, argue that the ACA is not an issue.

This isn't about 'being a man' or not—if you can provide proof for your speculation and conjecture about KY's hospitals, please do, but links to an organization whose goal is advocating for a single-payer national health system doesn't really make me feel better about your knowledge being unbiased.


My information isn't conjecture, anyone who's spent some time doing high end healthcare construction can confirm everything I've said. You not "being in the know" isn't my problem. Did you even look at the "cited sources" in the white paper you posted? They are worthless, but people without an academic background can't tell the difference. Frankly, it reads like a press release.

I've outlined whats happening here, you can choose to stick your head in the sand and pout about ACA all you like. Believe it or not, you certainly learned something new about the healthcare business by reading my posts and can now move forward more informed about the subject. I'm not a supporter of ACA, but its not the cause of these hospitals bad business decisions, they had plenty of time to adapt to the changing insurance business climate, as their competitors successfully did, ala Kaiser and Providence.


Let's get this straight. You are an expert because you do construction?



posted on Jun, 10 2015 @ 09:47 PM
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originally posted by: NavyDoc
Let's get this straight. You are an expert because you do construction?


What a simpleton perspective. Are you a real MD or is that just an avatar name? You would know EXACTLY what I was taking about if you had ever run a private practice at a for-profit hospital.

I work in the AEC Industry (Architecture Engineering and Construction) and not everyone in it is doing residential kitchen remodels, hence my statement "high end healthcare construction". How do you think hospitals with a construction cost of $200 million get built?

So yes, big contractors have a seat at the table with the hospital board, financiers and executive staff, pending on the size of the project. They are the experts that the people financing the projects rely on to get the work done on schedule and under budget. One of the business sectors I happen to cover is healthcare planning.
edit on 10-6-2015 by boohoo because: (no reason given)



posted on Jun, 10 2015 @ 11:50 PM
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a reply to: boohoo



Wow!Since I have built a couple of houses and a few toolsheds in my lifetime,I should go into medical practice!



posted on Jun, 11 2015 @ 06:51 AM
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a reply to: SlapMonkey

Go check hell and see if there are any snowball fights going on down there.



posted on Jun, 11 2015 @ 07:29 AM
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originally posted by: boohoo

originally posted by: NavyDoc
Let's get this straight. You are an expert because you do construction?


What a simpleton perspective. Are you a real MD or is that just an avatar name? You would know EXACTLY what I was taking about if you had ever run a private practice at a for-profit hospital.

I work in the AEC Industry (Architecture Engineering and Construction) and not everyone in it is doing residential kitchen remodels, hence my statement "high end healthcare construction". How do you think hospitals with a construction cost of $200 million get built?

So yes, big contractors have a seat at the table with the hospital board, financiers and executive staff, pending on the size of the project. They are the experts that the people financing the projects rely on to get the work done on schedule and under budget. One of the business sectors I happen to cover is healthcare planning.


But how does that make you an expert on the myriad tangle that is billing, reimbursement, RAC, record keeping mandates, EMTLA, etc?

You build stuff. We get it--but that really has nothing to do with the day to day running of a hospital. You get to see some of the budget that pertains to your project, but that is just a slice of the pie.



posted on Jun, 11 2015 @ 07:30 AM
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originally posted by: boohooMy information isn't conjecture


Here, let's examine that statement by starting with the definition of conjecture:


con·jec·ture
/kənˈjekCHər/
noun: conjecture; plural noun: conjectures

1. an opinion or conclusion formed on the basis of incomplete information.

synonyms: speculation, guesswork, surmise, fancy, presumption, assumption, theory, postulation, supposition...


I would postulate that all of your assumed guesswork, surmised possibilities, presumed happenings, theoretical suppositions on what the hospitals may have for expenditures, etc., is all fanciful speculation. There, did I get all of the synonyms in there? Either you don't understand what the word "conjecture" means, or just because you've had a bit of experience in what I gather to be other areas of the United States, you think that applies to all hospitals everywhere. Which is it?


...but people without an academic background can't tell the difference.


Ha, nice try--let's dispense of the passive-aggressive argumentum ad hominem and just say that you think I'm uneducated...then I'll laugh at you while reading it and then remember that your opinion of me doesn't mean anything and that you know nothing about me.


I've outlined whats happening here, you can choose to stick your head in the sand and pout about ACA all you like. Believe it or not, you certainly learned something new about the healthcare business by reading my posts and can now move forward more informed about the subject. I'm not a supporter of ACA, but its not the cause of these hospitals bad business decisions, they had plenty of time to adapt to the changing insurance business climate, as their competitors successfully did, ala Kaiser and Providence.


Apparently that's the main difference between your opinion and mine (which coincides with this KY hospital association, too): You blame the hospitals for not adapting (which, I concede, they could have), and I blame the government for passing this legislation that makes the financial lives of hospitals and many, many Americans, just that much harder. The thing is, you're blaming a symptom, while I'm blaming the cause that is pushing these hospitals over the edge.

I'm happy for you doing high-end hospital construction, and I really wish you the best in your business endeavors, but I think that this conversation has run its course, unless, like I asked prior, you can provide evidence of your conjecture about the KY hospitals and your claimed "real" reasons that they're in financial trouble. I'd be happy to read something like that if you care to provide it.

Also, your personal attack against NavyDoc really shed some light on your personality and your ignorance. His question to you was valid.




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