Oped: Hospital fee hike plan is risky

Andy Carter
Hospital and Healthsystem Association of Pa.

Each year during this time, policymakers in Harrisburg race to the June 30 budget deadline, working around the clock to finalize the details of the next year’s spending plan. For the last eight years, Pennsylvania’s hospital and health system community has played a key role in plugging budget gaps through a program known as the Quality Care Assessment (QCA).

We drove the creation of this program during the 2010 budget and, since fiscal year 2011, hospitals and health systems have contributed more than $1 billion to address budget shortfalls. This year will mark the fourth time hospitals have committed to help stabilize the state’s finances by providing new and flexible tax revenue for the state’s spending plan.

The QCA is designed to leverage federal Medicaid funding for hospital payments and provide support for the state budget. It’s supposed to be a win-win, a rising tide to lift all boats. And, for the most part, our partnership with the state has worked well.

This year’s budget debate, however, has proven to be challenging.The governor’s budget proposal calls for a significant increase in the amount of hospital money that would go to the state general fund.

Hospitals are hopeful the governor will reconsider his plan to take 60 percent more in hospital funds for the state budget. We need state policymakers to understand what is at risk if such a jump remains in the budget plan.

Pennsylvania’s hospital family is diverse, but we are united in a commitment to providing our communities with access to high-quality care. Unfortunately, more than a third of Pennsylvania’s hospitals are operating in the red. Any significant increase in the QCA could jeopardize the care that your community’s hospital provides.

We are committed to our partnership with the commonwealth, and we have made clear our wishes to continue with the QCA. As a show of our commitment, we have proposed a substantial increase in assistance for the general fund in this budget cycle and in our contribution during subsequent years.

We appreciate the opportunity to continue our discussions with the governor about the importance of a financially stable hospital community. We believe the compromise we have offered strikes the right balance between the need to support the general fund and the ability to continue to provide excellent care to Pennsylvania’s families. 

Policymakers must realize that health care has continued to significantly change since the QCA was created –– hospitals are prioritizing keeping people out of the hospital and delivering better-coordinated care. This means more outpatient services and a focus on health and wellness, chronic disease management and technology. Too large of an increase in the assessment would create uncertainty and instability and would make long-term and strategic planning nearly impossible. And patients could be on the losing end.

The hospital community is proud to partner with the governor and his administration to address the opioid crisis, to streamline care and to prevent overdoses. We are continuing to collaborate with policymakers to fit behavioral and mental health into physical health care plans. We are finding new ways of leveraging technology to expand access to care through telemedicine services and make it available to patients across Pennsylvania.

Hospitals’ partnership with government on these priorities has helped us make great strides in improving care, and our communities benefit as a result. Any major increase in the hospital contribution to the general fund could slow our progress.

The governor must ask: How do hospitals ensure services for care within the hospital; make the necessary investments in training, technology and infrastructure; and expand services in outpatient and community settings in the face of a major reallocation of resources?

We know there are no easy answers. And we know that in every budget cycle compromise is critical. We remain committed to working with the governor to take the steps to support the general fund at a reasonable amount and help hospitals continue to provide excellent care in the right place at the right time. It’s a win-win for the commonwealth.

— Andy Carter is president and CEO of the Hospital and Healthsystem Association of Pennsylvania.