As health care prices continue to rise, hospitals are feeling the squeeze.
The West Virginia Hospital Association is urging state and federal policymakers to help hospitals by increasing the amount of money provided to patients through government insurance programs.
Association President and CEO Jim Kaufman argued recently that West Virginia hospitals are at a disadvantage. He claimed 75 percent, or 3 out of 4 patients, receive their health insurance through government programs – Medicare, Medicaid, and the Public Employees Insurance Agency (PEIA).
Based on enrollment numbers from PEIA, the Centers for Medicare and Medicaid Services and data released by the West Virginia Center for Budget and Policy, that number may be closer to 61 percent.
West Virginia Public Broadcasting (WVPB) found that as of March 2022, 75,292 West Virginians are enrolled in PEIA and 442,545 in Medicare. As of July 2021, 584,000 West Virginians received Medicaid. This, however, does not account for the state’s uninsured population.
Kaufman said each of these programs pay hospitals less than the cost of care and these payment rates are non-negotiable since they are set by the government.
A report from the American Hospital Association (AHA) in April highlighted necessary hospital expenses have seen an increase from 2019 to 2021. Labor – which accounts for as much as 50 percent of a hospital’s expenses – have increased 19 percent, while drug expenses are up 37 percent.
In an email to WVPB, the West Virginia Department of Health and Human Resources – which manages the state’s Medicaid program – said the organization partners directly with the hospital association to ensure rates are appropriate.
Separately, the West Virginia Department of Administration – which manages PEIA – said via email they have increased reimbursements over the past two years, as well as pay 20 percent more for inpatient COVID cases. However, the email did state that reimbursements for inpatient hospital stays have not increased.
Appalachia Health News is a project of West Virginia Public Broadcasting with support from Charleston Area Medical Center and Marshall Health.