Hospitals Struggle With Underpaid Medicaid Reimbursements

By: Michel Mason Email
By: Michel Mason Email

Kentucky hospitals are losing millions of dollars every year due to medicare and medicaid reimbursements that are going unpaid.

Healthcare officials tell WYMT's Michel Mason the problem is worse here than anywhere else in the country.

Hospitals are fighting both the federal and state governments to make up millions of dollars lost each year on medicaid. ARH took a $16,000,000 hit last year, $13,000,000 of that, in Kentucky facilities alone.

"It creates quite a shortfall for us and has a big impact on our ability to deliver care," said Chief Financial Officer of ARH Joe Grossman.

Grossman says ARH cares for twice the number of medicaid and uninsured patients than other Kentucky hospitals.

"And when you put on top of that the shortfalls in reimbursements from both federal and state, that puts us in a very challenging situation in order for us to pay our employees and maintain our facilities," added Grossman.

Hospitals aren't the only ones suffering because of this problem. Families who have health insurance pay an estimated $1,100 more every year because the government is unable to pay the entire tab for medicare and medicaid.

Medicaid makes up 18% of Pikeville Medical Center's patient load. Luckily, unpaid reimbursements are not forcing them to cut staff.

"You're probably going to see some medical facilities that just can't survive and that's going to be unfortunate for everybody," said Keith Bridges, Assistant Vice President of Public Relations & Marketing for Pikeville Medical Center.

Hospitals continue to negotiate with the state and federal governments for whatever they can get.

ARH is among dozens of Kentucky hospitals suing the state for underpaid medicaid funds since 2004.

Pikeville Medical Center is not part of that lawsuit.


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  • by Me Location: Jackson Co on Feb 13, 2009 at 11:27 AM
    Maybe hospitals will quit trying to see how many tests they can run on a patient, just because they have Medicaid now. I've seen it numerous times. Happened to my mother in law. She was having dizzy spells & even blacked out for a few seconds, she went to emergency room and they admitted her for 4 days! She wanted to go home, but they said they advised her to stay there. During that time they ran different scans, tests, lab work, etc. and never did find out what was causing her dizziness to be honest. Guess what? Yeah, she has Medicaid! I have another suggestion - quit giving a Medicaid card to people who don't really need it! There are plenty of young healthy adults who receive Medicaid, and they should be working to pay for their own insurance. I don't even have a problem with Medicaid helping low income people who have insurance, but need help with deductibles & co-payments. At least they're trying to help themselves.

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