Capitol Hill lawmakers who are crafting a health care reform package are being urged to consider the effects of reform on public hospitals. Among those issuing the call is John Bluford, President and CEO of Kansas City-based Truman Medical Centers , which includes Truman Medical Center Hospital Hill and Truman Medical Center Lakewood in Kansas City.

Public hospitals, some of which Bluford calls safety net hospitals, provide services to many Medicaid patients and individuals who are uninsured and underinsured.

“First and foremost, we need to get these 46- or 47-million people in our country who are not insured – we need to have coverage for those people,” said Bluford in an interview with the Missourinet. “That relates very directly to the viability of these safety net hospitals – public hospitals and so forth.”

Bluford says many of these hospitals are level one trauma centers delivering emergency care to the uninsured or underinsured.

“Many of those things (trauma cases, high-risk pregnancies, etc.) currently, because of the uninsured dilemma, are not being reimbursed for,” said Bluford. “They, (the hospitals) in effect, are vulnerable, themselves, as institutions.”

Bluford says many of these public hospitals are not receiving reimbursement rates at levels that can sustain continued delivery of services.

“There must be a protection for disproportionate share payments,” said Bluford. “That’s an industry term but, in effect, it is a subsidy for these safety net institutions that cover a disproportionate share of uncompensated care individuals and Medicaid individuals.”

Bluford says Truman Medical Center hospitals are usually at capacity and need to expand, but he says it is difficult to do so because the low reimbursement rates and other factors stand in the way of generating the revenues needed for expansion.

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