Hospitals that serve Florida's neediest patients concerned about proposed change to Medicaid payments
Hospitals that serve Florida's neediest patients stand to lose the most under a new system for how the state doles out Medicaid dollars.
The DRG payment model — or "diagnosis-related group" — would categorize Medicaid patients based on the type and severity of illness and pay hospitals accordingly. Currently, hospitals are paid various daily rates based on actual costs.
Dozens of hospitals stand to receive more Medicaid dollars under DRG, but representatives of the state's 15 "safety net" hospitals say their facilities are among the biggest losers. That includes Tampa General Hospital and Miami's Jackson Memorial Hospital.
Advocates say the model should be tweaked so that these hospitals, which serve the state's poorest and most severely injured patients and are often the training ground for future doctors, are held harmless.
The state Agency for Health Care Administration has run the numbers showing what each hospital could receive under DRG compared to the status quo in the 2013-2014 fiscal year.
Jackson Memorial would drop from $345.6 million to $301.2 million. Tampa General Hospital's payment would decrease from $139.5 million to $128.2 million.
Even though the model was tweaked in a way that benefits the state's two freestanding children's hospitals, All Children's in St. Petersburg and Miami Children's would lose $9 million and $1.4 million respectively.
None of the 13 hospitals that draw from Medicaid the most — those in line for more than $50 million annually — stand to see increases under DRG. Ten of these are "safety nets" and all but one is not-for-profit.
On the other hand, most of the hospitals that see the biggest increases under DRG are operated by for-profit companies.