Brian Keeley, chief executive of Baptist Health South Florida, offered the wisest response to news that Jackson Health System has stopped paying for outpatient dialysis for 175 poor patients. He suggested a "public-private partnership" of hospitals to provide care for those without insurance and those who can't qualify for insurance.
He's absolutely right, and Friday three hospitals agreed to do just that. Mr. Keeley's Baptist Health, the University of Miami and Mercy Hospital agreed to take on 40 of Jackson's dialysis patients for a month. Now they and other local care-givers should start to work on a plan that will provide indigent kidney patients care until a long-term solution can be found.
Jackson is struggling with a projected loss of $168 million in 2010, and it is on a cost-cutting mission of necessity. By dropping coverage of outpatient dialysis the hospital system saves $4.2 million. Jackson will still provide dialysis in its ER, but, ironically, it will cost more than at the outpatient centers. Medicare and Medicaid will reimburse some costs, but Medicare is scheduled to reduce its dialysis reimbursements.
Jackson is charged with caring for all of Miami-Dade's poor, underinsured and uninsured residents. The facility treats thousands of undocumented immigrants in its emergency room, adding to its financial burden since those patients can't get Medicare, and Medicaid only covers some costs. Though it receives millions of dollars annually in federal, state and local money (including a half penny of sales tax proceeds), the hospital's costs keep going up as the population expands.
Add the recession to that mix, and Jackson's deficit was inevitable.
Jackson isn't alone. Public hospitals elsewhere are facing cost-cutting, and dropping dialysis is becoming a painful option. Grady Memorial Hospital, Atlanta's public facility, tried closing its out-patient dialysis unit in October. It offered to return undocumented immigrants to their home countries and pay for treatment there temporarily. Some accepted. But poor legal residents and citizens still needed dialysis from somewhere.
The hospital's decision caused a public outcry. And a lawsuit. Just last week Grady agreed to keep paying through Feb. 3 for 50 patients needing treatment. This controversy is far from over.
To read the complete editorial, visit The Miami Herald.
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