Calling Fox Mulder. The truth is out there, but it appears no one in mainstream media is interested in doing any actual reporting. That’s the obvious conclusion drawn from the repeated insinuations and blame-heaping being cast by leftists and their media allies as St. Francis Hospital in Topeka circles the drain.
It’s embarrassing to watch.
Medicaid expansion won’t save St. Francis Hospital, and it’s obvious to anyone who has spent half a second examining the issue with a critical eye. The only thing that keeps the doors open at the Topeka hospital is a buyer or a willingness by management to invest in the it. Still, St. Francis Hospital President David Setchel again cast blame on a lack of Medicaid expansion instead of taking full responsibility for failures of his own leadership.
“I’m not going to say failure to expand Medicaid is the sole reason why — it’s a big reason why,” Setchel said at a forum to promote KanCare expansion.
SCL Health Care Systems, formerly known as Sisters of Charity of Leavenworth, is a non-profit organization that made millions in 2015, according to its financial disclosures. Compared to other health systems, SCL Health’s earnings are a pittance, but a profit is a profit. In comparison, Ascensions Health Systems, the owner of Wichita’s Via Christi Hospital, raked in $477.7 million in 2016. Ascensions’ leadership is also calling on Kansas taxpayers to pony up $1.1 billion for Medicaid expansion, arguing that the hospital reduced its staff due to budget challenges in 2016.
Rural hospitals are facing challenges nationwide. Some of those challenges can be laid at the feet of government intervention. Medicaid and Medicare reimbursements don’t cover the costs of actual care, a primary reason many hospitals are losing money. In fact, St. Francis reported it lost $12.5 million in 2016, but it’s parent-company turned a profit.
When SCL Health announced it would seek a purchaser for St. Francis, officials admitted hospital ownership is fiscally healthy and that the owners weren’t using extra cash to invest in the Topeka hospital.
“The hospital is financially strong, but the investment in the medical group needs improvement,” Nikki Sloup, a director of marketing and communications at St. Francis told the Topeka Capital-Journal last year. “We are part of a larger system that is supporting our operation, but with St. Francis being the only hospital in our system located in Kansas, our ability to negotiate with payors is limited.”
SCL Health Begins Divesting from Kansas
SCL Health began diverting resources away from Kansas back in 2007, before the Affordable Health Care Act, or Obamacare, was rammed through the U.S. Congress, and before Medicaid expansion was even an option for the states. In 2007, Sisters of Charity of Leavenworth leaders purchased three hospitals in Colorado. Shortly thereafter, leadership moved the headquarters to the Denver-area and sold all of its Kansas properties with the exception of St. Francis Hospital.
SCL’s divestment from Kansas occurred at about the same time the health care industry saw a dramatic shift. In an age of increasing outpatient care, enormous hospitals with hundreds of beds are becoming obsolete. According to the American Hospital Association, inpatient hospital admissions are plummeting, while outpatient care is increasing. Between 2010 and 2014, inpatient admissions dropped by 2 million, while outpatient visits jumped by more than 42 million. St. Francis has 378 beds and a highly-profitable hospital with more than 500 beds, Stormont-Vail, sits less than a mile away.
Meanwhile, Medicaid expansion proponents admit that expanding Medicaid may not save hospitals. Legislators said as much during expansion debate in the Kansas House, according to Rep. Blake Carpenter.
“At the well, (expansion proponents) ended up saying, just because we pass Medicaid expansion that doesn’t mean it will save hospitals. It will potentially save some,” Carpenter said.
In some instances, Medicaid expansion could hurt hospitals. A spokeswoman for the Kansas Hospital Association told the Topeka-Capital-Journal that Medicaid expansion would help hospitals, and then noted that it only pays about 60 percent of the cost of care. She called it better than nothing, but is it?
It’s a bandage on a gaping wound, because the privately-insured and taxpayers are picking up the tab. That’s causing the cost of private insurance to increase while simultaneously siphoning the number of privately insured individuals. According to Kansas Health Institute, approximately 71,000 of the people who would be added to Medicaid rolls under expansion already have private health insurance.
Medicaid expansion advocates tossed logic in the garbage months ago. Every reason advocates cite for for expansion is filled with emotion and bereft of reasoning. People will die, they warn, in an unprovable emotion-filled argument. The opposite may be true. People without Medicaid have better health outcomes, according to one study. An Oregon study suggests people enrolled in Medicaid fare worse health than those without any insurance.
Future Uncertain for Hospitals, Obamacare
Like the hospitals advocates say they want to save, Obamacare’s future is uncertain. The federal funding available to states for Medicaid is shrinking and may completely evaporate as federal legislators work to repeal Obamacare–the policy that created the Medicaid expansion debate.
Hospitals will close whether Kansas expands Medicaid, just as they are continuing to close in the states that expanded. Since 2010, 80 rural hospitals have closed in the U.S., and many are in states that expanded Medicaid. Hospitals closed in California, Michigan, Minnesota, Ohio, and Pennsylvania, states with expansion. And they also closed in Texas, Mississippi, Missouri, Kansas, and Maine–states that didn’t expand. The primary difference between the closings appears to be that some hospital management took responsibility for their own mismanagement, whereas in Kansas at St. Francis, leadership would rather cast blame on the Governor’s veto pen. It’s a pretty shameful display by adults.
The possibility of St. Francis closing is a red herring designed to play on people’s emotions and score political points. The truth is out there, but don’t count on anyone in mainstream media looking for it.