Grady Memorial Hospital in downtown Atlanta provided $180 million worth of uncompensated care services in 2017. Stanley Dunlap/Georgia Recorder
Georgia leaders have long grappled with ways to fairly distribute the responsibility of treating patients who can’t afford to pay, a provision known as indigent and charity care provided by hospitals.
House lawmakers and health care officials are now studying a proposed system that some Republican backers say could better serve uninsured Georgians and the hospitals that care for them. And supporters say, it might even spur innovation.
That new system, called the Georgia Exchange Charity Care Exchange, would be a regulated pool that allows care facilities to buy and sell charity care credits.
So how would it work?
The state would set the minimum level of indigent care that hospitals must provide. Hospitals that do not meet that baseline could instead buy charity care credits from hospitals that take on patient costs above that threshold.
Atlanta’s Grady Memorial Hospital provided $180 million of uncompensated care in 2017, so it could sell its credits for cash to go into a general fund or maybe exchange it for diagnostic equipment, said Rep. Todd Jones, a Cumming Republican, and chairman of the new legislative study committee.
“If you are not able to hit your floor and not an outside-the-box thinker… then you do put yourself in a position where you do become a payer into the system,” Jones said. “My hunch is a lot of boards of those hospitals and those providers will work really hard to find innovations with the way they deliver care.
“Maybe they open a satellite location to bring in a greater amount of charity care,” Jones added. “What we want now is for them looking for greater ways to solve the problem.”
The plan is not to replace the state’s Indigent Care Trust Fund, created in the 1990s to help cover medical care costs for uninsured people living in poverty.
The state now requires hospitals spend 3% of adjusted gross revenue on indigent care or pay the equivalent amount into the fund.
The new policy would allow each medical care facility to determine how it uses the credits instead of the state.
“The beauty here is the people who are performing the service are determining where the capital should go, not the government,” Jones said.
Some health care organizations like the Georgia Hospital Association and Emory Health are a bit skeptical of the program, at least until the new system is more developed.
Georgia hospitals reported providing $2.1 billion in uncompensated care in 2017, according to the Georgia Hospital Association.
“We have this money from the shortfalls coming into the Indigent Care Trust Fund, which also gets matched with federal dollars and goes back out to hospitals,” Keri Conley, an attorney and senior vice-president of health care policy for the hospital association, said at Wednesday’s committee meeting. “If you have a hospital like Grady… they get more (funds) than a hospital that does not do as much uncompensated care.”
The study committee was created from charity care legislation in the form of House Bill 542, which is pending ahead of the 2020 legislative session.
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