April 28, 2016

UNM Hospital will see biggest Medicaid cuts

Andy Lyman

University of New Mexico Hospital

News that the state Human Services Department is planning to cut between $26 million and $33.5 million through how much the state pays for Medicaid provider payment rates filled healthcare advocates with grief, if not surprise, this week.

University of New Mexico Hospital

Andy Lyman

University of New Mexico Hospital

It’s how the state agency is saving the biggest cuts—which will affect Medicaid payment rates for doctors, hospitals and dentists—for New Mexico’s biggest hospital that’s causing the most controversy in some circles.

By this July, the state plans on cutting Medicaid payments at the University of New Mexico Hospital (UNMH) to inpatient services by 8 percent and outpatient services by 5 percent. That’s bigger than the 5 percent inpatient and 3 percent outpatient Medicaid cuts that the rest of the hospitals in the state will see.

Lorie MacIver, a UNMH nurse and president of District 1199 of the National Union of Hospital and Health Care Employees, says the cuts will disproportionately hurt UNMH patients because the hospital is the only Level 1 trauma center in New Mexico equipped to treat the most serious injuries and health conditions.

“The most critically injured people go to a level 1 [hospital],” MacIver said. “We get the sickest of the sick.”

She pointed to a failed attempt by the Human Services Department to request $50 million from the hospital’s reserves to help pay for the state’s $86 million shortfall in Medicaid, the federal healthcare program for the poor. UNMH has $220 million stockpiled toward building a new hospital to replace its outdated facility built in the 1950s.

As NM Political Report previously reported, Human Services Department top brass met in February with top officials from the university’s Health Sciences Center, which oversees UNMH.

The Human Services Department withdrew its request after HSC Chief Executive Officer Paul Roth and UNMH CEO Steve McKernan told them that several boards would have to approve such a request.

“To me what it smacks of is they ask for the money, they didn’t get the money and now they’re just mad,” MacIver said, adding that the “everyday person who is sick” will suffer in return.

The Medicaid deficit comes as part of a larger shortfall in state government this year prompted by falling oil and gas prices. Earlier this year, the Human Services Department appointed a 12-member subcommittee made up of healthcare and hospital professionals to make recommendations on how to best cut $86 million from Medicaid. In the end, the subcommittee recommended cutting between $18.5 million and $25 million. Making disproportionate cuts to UNMH was not among the recommendations.

Human Services Department spokesman Kyler Nerison didn’t respond a voicemail or email from NM Political Report for this story.

Earlier this week, Nerison told the Albuquerque Journal that UNMH previously benefitted in funding from the state’s decision to expand Medicaid under the federal Affordable Care Act and gets $90 million a year from Bernalillo County taxpayers as part of a mill levy. Nerison also referred to UNMH as a “big government” bureaucracy and told the newspaper that the state instead prioritizes “protecting benefits for those who need health care the most.”

In a prepared statement, HSC spokesman Billy Sparks noted that “all hospitals in New Mexico including UNMH received additional revenue based on the expansion of Medicaid and as a result thousands of New Mexicans receiving medical coverage.”

Sparks added that HSC is analyzing the Human Services Department’s planned Medicaid cuts and will respond once they are formally proposed.

Two days after HSC rejected giving $50 million to the Human Services Department to solve the Medicaid shortfall funding, two university regents instructed university counsel to begin making draft changes to the guidelines governing the HSC board of directors.

This led to a controversial overhaul in March that eliminated two community members from input on HSC decisions. Instead, governor-appointed regents now make up a subcommittee that directly deals with HSC matters.

One of the eliminated community members, Mel Eaves, directed criticism at the Gov. Susana Martinez administration for previously blocking efforts to build the new hospital and Lovelace, a Martinez campaign donor that also previously opposed the new hospital.