With Tampa General losing millions each month, hospital president Bruce Siegel hopes to get two major changes pushed through the Legislature this spring that could bring $20-million a year in cash.
The hospital's executives want $10-million for teaching state medical students, and they also hope to get about $10.6-million from a plan by Gov. Jeb Bush to increase how much Medicaid pays hospitals for treating the poor.
The two proposals come at what Siegel recently called a critical time for the 877-bed hospital on Davis Islands. In the first two years after converting to a private hospital in 1997, Tampa General lost more than $21-million, despite promises by Siegel that going private would improve the hospital's finances. In the past three months, the hospital has lost another $6.2-million.
In another worrisome sign, an executive from the New York company that insures $149-million in TGH's bonds attended a private board meeting at the hospital last week. Hospital spokesman John Dunn called the visit "cordial," but would not comment on it.
Siegel did not make himself available for an interview this week, but his vice president for government affairs, Marcos Lorenzo, said the legislative proposals would help the hospital begin to heal financially.
"It is very good medicine," Lorenzo said.
But the proposals already face hurdles: Bush's plan to increase Medicaid funding would require local governments across the state to provide $32-million to the program. No one knows where that money might come from.
And some legislators said they won't support a $10-million appropriation for Tampa General's teaching mission unless management changes.
"I would be very cautious throwing good money after bad at a time when the management has not been able to deliver on its promises to the community," said state Sen. Tom Lee, R-Brandon.
"Right now, my confidence level in Tampa General is about zero," he added.
But Lorenzo said legislators understand Tampa General needs state support as a regional medical center. The hospital teaches state medical students and treats patients from around the state in its emergency room.
"I cannot sit idly by and watch the hospital close," said state Sen. Jim Sebesta, R-St. Petersburg. "It's tragic that Central Florida's only Level One trauma center is itself bleeding to death."
Sebesta and state Rep. Sandy Murman, R-Tampa, who sits on a key House appropriations committee, sponsored the $10-million request for TGH. Other teaching hospitals historically have gotten the same state money Tampa General now wants.
Bush's proposal would lift reimbursement caps on how much hospitals get paid per day for treating Medicaid patients.
Medicaid, the federal-state medical program created in 1965, was supposed to pay hospitals what it costs them to care for poor patients. But the program has never kept up with actual costs, said Tony Carvalho, senior vice president of the Association of Community Hospitals and Health Systems of Florida, which represents 90 non-profit and public hospitals in the state.
So Bush proposed increasing the reimbursement ceiling for about 70 hospitals, including Tampa General and Bayfront Medical Center in St. Petersburg. He also wants to increase what Medicaid will pay for outpatient care from $1,000 to $1,500 a year.
The increases wouldn't be a bonanza for most hospitals. The extra money from Medicaid would just offset an expected $16-million cut in another government program that helps many hospitals. "But it's a good start," said Carvalho.
Right now, Bush also plans to take $14.5-million from existing medical programs to fund the increases. Tampa General's lobbyists don't like that idea because it would take money from one program to boost another.
_ Staff writer David Karp can be reached at (813) 226-3376 or at karpsptimes.com.