Secrets of the City

HCMS has been in financial trouble for some time. The only county-owned hospital in the metro area, they also provide more indegent care than any other hospital in the state (Regions Hospital in St. Paul is #2). No other hospital in MN comes close to the uninsured HCMC treats.

You see why health care reform is so important?

In a limited way, this is good. It will force other counties to take care of their own “problems.” Very often counties will drop mentally ill people at the front door of HCMC instead of taking care of their own. While I have very little faith that the other counties will do anything to help their own, in may bring into focus the good deeds HCMC provides state wide, not to just Hennepin County.

But other than that, it totally sucks.

KC is right about the dumping of out-of-county patients at HCMC. We saw that at Regions, too.

Yes, Regions has that problem also. People would rather dump their problems on the urban areas than admit they have problems of their own.

What if they feel that they don’t have the resources needed to care for these people, and maybe a larger hospital would?

That seems to be a bit of a different situation than the dumping problem that kc and bob are talking about. In the case you describe, the patient’s county of residence should be contacting HCMC itself to arrange treatment and payment.

@baker: Hospitals don’t get much bigger than HCMC. Nor is a for-profit hospital, e.g. Fairview, likely to be as generous to charitable cases under any circumstance.

baker, they don’t have the resources and are unwilling to invest in them because they can dump the people who need them somewhere else.

“No other hospital in MN comes close to the uninsured HCMC treats.”

That’s because they are required to by law. While non-profit hospitals are required to treat all emergent cases irregardless of lack of insurance or the ability to pay, a county hospital cannot turn people away no matter what.

Fairview is non-profit, IIRC, noodleman. I don’t think there is a for-profit hospital in the Metro.

@aliecat: News to me. Thanks!

KC is probably correct some dumping is done. Fund the indigent through the state, if it has to be funded, it will cut down on inefficiencies between the county and the state bureaucracy. But do not expand the program past that point and contain the cost within Hennepin county. Cost containment is key.

Swandog, HCMC is not compensated or funded for indigent care of people who live outside of Hennepin county at all. That expense is probably either written off as charity care (that all hospitals are required to provide at some level) or as bad debt. They are simply now having to be tougher about enforcing the no non-emergent care for outside residents.

Oh, and I should say that HCMC was probably attempting to get the indigent enrolled in GMAC to cover the care they provided, which is no longer an option for them.

@aliecat- true, the state will have to in eventually bail them out. The county will either have to borrow the money from the state or close the doors. It is probably better to have the state fund it directly, but that will not happen due to politics of the situation. In the end it will be a cost shifting game.

Aren’t all hospitals nonprofit?

Kwatt, not all. It’s a voluntary thing. But, yeah, I would argue that all most all in this state are non-profit…except for that cancer center that had all that trouble.

That was non-profit too, Alie. Unless you’re talking about a different one.

(and that was a clinic, not a hosptial.)

ORLY? For some reason I thought the Strib mentioned that they were for-profit…hmm.

Pretty sure. I did a quick google search to confirm it, and couldn’t find anything to contradict myself. Plus, I worked there for 3 years. (In the research division, not the clinic division)

Ahh..well, I don’t know where I got that from!

I suppose people get the impression some medical institutions are for-profit because of the six-figures compensation we see bandied about in the news. I’m sure it’s not universally true but to argue that would be as difficult as convincing someone that airline pilots aren’t all paid $150k per year. Malpractice insurance is also pricing some medical practitioners out of the field, and people forget that a doctor often pays that out of their own pocket.

There was, for a period of time, a for-profit division or subsidiary (not sure how exactly things were set up) for developing/marketing/licensing stuff from the research division.

Yeah, a lot of those salaries are for top execs, doctors are paid based on Relative value units (RVUs), i.e. how many patients they see. Basically, it’s the billable hour of the medical field. Much of the profits hospitals see is turned around to purchase and update medical equipment or capital spending.

Also, the death of the private practice is due in part to the complexities of the insurance billing supermachine. Admin costs associated with hiring a coder, medical biller, and ensuring that you are sending out compliant claims will kill a small practice quicker than high malpractice premiums.