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9/11/2013 6:00:00 AM
Repeal attempt worries Kingman Regional officials
Brian Turney
Brian Turney

Suzanne Adams-Ockrassa
Miner Staff Reporter


KINGMAN - CEO Brian Turney said Kingman Regional Medical Center could lose $8 million a year in Medicaid reimbursements if an attempt to repeal the expansion of the Arizona Health Care Cost Containment System succeeds.

Turney made the comment while describing the impact the Affordable Care Act would have on the hospital at an educational series hosted by KRMC's Joan and Diana Hospice House Tuesday.

A group of conservative Republicans, including former Arizona Sen. Ron Gould, R-Lake Havasu, has been circulating petitions to gather enough signatures to put the expansion of AHCCCS on the 2014 ballot.

According to the Associated Press, the organization needs to turn in more than 86,000 valid signatures by 5 p.m. today in order to get the issue on the ballot. As of Tuesday afternoon the group had just over 81,000 signatures.

Gov. Jan Brewer pushed the expansion of AHCCCS through the Legislature earlier this year. It will go into effect in January and will add another 300,000 Arizona residents to AHCCCS' rolls.

The expansion of AHCCCS will help cut the amount of medical care the hospital isn't compensated for by adding more people to the state's insurance rolls, Turney said. That means fewer people coming in without health insurance who can't pay their bills.

KRMC first started seeing an increase in the amount of uncompensated care it was paying for in 2011, after the Arizona Legislature kicked more than 160,000 adults without children off of AHCCCS rolls, Turney said. The effect of the enrollment cuts is magnified by the fact that the state has cut AHCCCS reimbursements to hospitals by 5 percent twice over the last four years.

The hospital has a $225 million annual budget, he said. In 2011, the hospital spent $9.6 million on uncompensated care. This year, the hospital spent $13.9 million.

Nearly 60 percent of the hospital's income comes from patients with private insurance, Turney said. But nearly 60 percent of the patients KRMC sees have Medicare, around 19 percent have private insurance, 15 percent have Medicaid/AHCCCS and 8 percent attempt to pay out of pocket.

Medicare reimburses the hospital at a rate of about 21 percent, he said. Medicaid/AHCCCS pays about 17 percent and people attempting to pay out of pocket make up the last 2 percent.

But even if more people are covered under AHCCCS, state hospitals are still going to have a problem with uncompensated care, Turney said. The AHCCCS expansion will only cover patients who make up to 138 percent of the federal poverty level.

According to the U.S. Department of Health and Human Services, the 2013 poverty level for a family of four is $23,550 and $11,490 for an individual.

The Affordable Care Act will start penalizing individuals and families without health insurance $95 a person, up to a maximum of three people, in 2014, he said. That penalty will increase incrementally to $695 per person in 2016. Everyone up to 400 percent of the federal poverty level will be eligible for federal subsides to purchase health insurance.

But $95 a person may not be enough of an incentive to get people to purchase health insurance, he said, when insurance plans could cost as much as $300 or $400 a month.

Turney said the exact figures for health insurance sold through the state health exchanges have not been determined yet.

The ACA is expected to cost the federal government $928 billion and save the government $124 billion over the next 10 years according to the Congressional Budget Office, Turney said.

"I know this is hard for some people to believe, but what happens to us as a hospital impacts the community," he said.

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Reader Comments

Posted: Tuesday, December 24, 2013
Article comment by: Learn about the ACA

To Origional:

Oh you are absolutely right. When you assist a working poor person to actually help them buy their own health care at a price they can afford, that subsidy is coming from taxpayers.
That's not a secret.

But now lets look at the flip side ---- Would you prefer this person get worse and worse, until they finally can't work at all? And then ask for $2500 per month for Social Security Disability from the government for the next 50 years?
Is that the better option?
Because that IS what is happening right now.
I would MUCH rather see taxpayer paying a $200 per month subsidy instead of paying that $2500 per month full benefit for a person who can't work any longer.
With health insurance, that person with the subsidy has a chance to stay well --- maybe even healthy enough to start earning higher pay that takes them above the subsidy.
It doesn't take a rocket scientist to understand how providing coverage to all of our residents actually benefits the nation as a whole --- and that means benefits all taxpayers in the end.
(Seriously -- have you not ever pondered why every *functioning* nation in our world already does this?)


Posted: Saturday, September 14, 2013
Article comment by: Origional Kingman Resident

@ Learn About the ACA

Dig a little deeper....

If your hypothetical man earning 19k a year only pays $75 a month for insurance, how is the remainder of the cost of his insurance going to be paid for? Insurance doesn't magically get cheap because a 2000 page law is passed.

Subsidies is another word for, other people's money.





Posted: Saturday, September 14, 2013
Article comment by: anonymous anonymous

I am a veteran, VA medical care, that dreaded socialized medical care!:-) I was at the VA in Tucson returning to my truck and noted a mini-van next to mine, on back of van a sticker "vote Romney 2012 do away with Obama Care" I smiled found humor here was a fellow who was getting socialized medical care and in same breath likely ranting when and if they could find anyone to listen about anyone else getting even half what they get which Obama care is only medical care reform by no means anything close to what I get as a veteran! I still find that a irony, truly if one wishes to end the leeches on the sick, who bleed them do away with the insurance companies in the health industry they are like a vampire or leech sucking the blood from the sick!

Posted: Friday, September 13, 2013
Article comment by: DENISE BENSUSAN

The PEOPLE need to come together and fight the folks passing this ridiculous petition around. This is disgusting, those same Americans who want to deprive America of decent health care and keep this VERY VALUABLE asset Kingman Regional Hospital.....which we are darn lucky to have in our town are probably the same people that support the WARS we spend TRILLIONS on (and that is only the monies they admit spending and does not include the covert UNLIMITED budget that they spend like it grows on trees) and they seem thrilled to do so. Are we this stupid in America that we can’t negotiate and TALK to other countries even if we disagree on issues. TALKING….interesting way to clear things up!
KRMC saved my life several times this year………THANK YOU BY THE WAY! Until you are seriously ill you have NO idea how important these facilities and staff are. ALL Americans should have the opportunity to be healthy. Healthy people support the economy by being able to work and be productive. We are the only nationalized and free country in the world who DO NOT have a national health care plan. KRMC needs to fight this with everything they have. We need you here and are LUCKY to have this facility in this small of a community.
It’s called HUMANITY by the way! denisebensusan@speakoutarizona.com


Posted: Friday, September 13, 2013
Article comment by: DENISE BENSUSAN

[Comment exceeded word limit.]

Posted: Thursday, September 12, 2013
Article comment by: Eric Downey

"KRMC"greed is where you are now, I live in Kingman and I travel to bullhead or fort mohave to see doctors or hospital, I have private insurance and feel that the krmc is pricing me to death

Posted: Thursday, September 12, 2013
Article comment by: This is why we pay so much

I know several people who work for Lingenfelter's Alzheimers center and make so little that they are on Medicaid.

To the guy saying use Charity hospitals if you don't qualify for Medicaid? Obviously you have never used a Charity hospital -- they don't cover your drugs NOR do they cover your treatments.

They will tell you what's wrong with you, but to SAVE you from dying from that illness, you need to have money or insurance for that.

And one last thing Obamacare can be an HMO, or PPO or pretty much anything that any insurance company offers. Because you BUY from insurance companies, just like always but now with you can qualify for subsidies to help lower the premiums for you.

For 44 years we tried a single payer (Expanded Medicare to all) but Republicans voted that down every time. Even a public option -- to COMPETE with the private insurance ---- was not acceptable to a single Republican Congressman. .

I wish more hospitals would come out and talk about how lack of health care is why the rest of us have to pay HUGE costs just to help when we are sick.


Posted: Thursday, September 12, 2013
Article comment by: krmc victum

I've had the exact same medical procedure performed three times at KRMC over the past 5 years. First KRMC billed $2000, then $4000, then $6600. The procedure has been around for over 60 years and the medication is only $111. The only think that increased is KRMC's greed.

And I remember the auto insurance scam. Mandatory auto insurance had not reduced rates.


Posted: Wednesday, September 11, 2013
Article comment by: vock canyon

i don't get it, I don't see how the hospital spent 6% of it's income that it didn't recieve. I can only guess that he must be talking about accounts recievable. Since these accounts are tax deductable, I wonder what the true after tax loss is. Then there is actual costs of VS the billed charges. The mark up in the medical field is quit high, so perhaps the actual loss is in the 2% range, well with in a normal range for a businesses loss. $225 million income from a community of perhaps 50k, that's like $4500 for each man women and child in this community each year. I think these numbers are very confusing, and are intended to be.

That said, each time I've been there I've had excellent service.


Posted: Wednesday, September 11, 2013
Article comment by: L J

I guess the CEO & the board of directors should have thought of that when KRMC brought HMMC center. Be interested to know exactly what there actual costs are
vs. the amount they bill? Non-profit?


Posted: Wednesday, September 11, 2013
Article comment by: mr. parker

@OneQ: According to census.gov, Mohave County has a population of 24.9% that is over 65. AZ as a whole has 14.8% over 65.

So with the hospital receiving 60% of its revenue from Medicare, it's not unusually high. Plus as you get older, there is more of a chance that you are going to be treated for life threatening illnesses and treatment for degenerative diseases.

@CliffF.: $10 for a Tylenol tablet. $20,000 for an ambulance ride, etc.
We all agree we need health care reform. Insurance portability,tort reform and coverage for pre-existing conditions. Unfortunately, obamacare is
not reform, it's control. Like mandatory auto insurance, it's only going to increase in price. Bureaucrats, health care "navigators", lawyers, win.
Doctors, patients, we lose.

Hospitals must treat anyone who presents to an ER. Compassion dictates that we help these people but many abuse the ER with complaints that would be better treated in a physicians office or a clinic.

What's more problematic is the $9.6 million that the hospital apparently writes off every year. Who are those people? Are they hard working citizens who simply can't afford care? Or are they methheads or illegals?


Posted: Wednesday, September 11, 2013
Article comment by: for a better kingman

Turney's salary is a half a million per year. No need to take my word for it- look at the KRMC 990 on line. This is in addition to all the other administrators' salaries. Millions and millions for paper pushers. Send em all packing and there is your 8 million shortfall.

Posted: Wednesday, September 11, 2013
Article comment by: Learn about the ACA

Let's get some facts here -----

People who need to buy insurance on their own will ALSO get a sliding scale subsidy all the way up to those families making $80,000.

The Affordable Care Act calculator at kff.org says that a single, 40 year old man making $19,000 per year will only have to pay $74.50 per month for a silver plan (70/30) -- which includes free well visits and many free exams.(he pays less than 5% of his income toward premiums, with an annual out of pocket cap)
That same man can also choose the 60/40 Bronze plan, which will cost him even less.

$75 monthly for a full coverage health plan is CHEAP!

ACA is set up so that the insurance plan you buy will NOT EVER cost you more than 10% of your income, unless you are in the higher income brackets.



Posted: Wednesday, September 11, 2013
Article comment by: trained observer

@Mr. Turney afford their tooth whitening

----
I know Mr.Turney. I can assure you he has naturally good teeth that are not darkened due to ingesting substances like coffee or smoking. He was also blessed with good genes.

I can see that a torrent of letters will be forthcoming about how we need to boot all these loafers off the system, the hospital is greedy etc etc.
The fact is that quite a few people suffered economic injury due to layoffs in the recession. Many have not recovered despite all efforts. I think showing a slight bit of compassion for other people personifies many people in this community's alleged "Christian values." The second fact is that KRMC has invested in technology to offer quality services to the community. It is also the largest private employer in the area. Think for yourself and not because your political party tells you how to think.


Posted: Wednesday, September 11, 2013
Article comment by: Concerned One

Do you really think Mr. Turney is going to release all the number to the public ? Don't be foolish.. Did he mention the millions of dollars they are receiving for being the only medical provider in the are ? I think not.. So, if KRMC could lose 8 million a year from Medicaid reimbursements, what is the total that they are receiving.. 8 million is just a fraction of their overall income and worth.. Oh , they have no income, KRMC status is not for profit, so to be under that category they have to provide charity care, while investing their so called non- profit funds in purchasing land and other buildings, while your less fortunate employees struggle to make a living.. You know the departments.. So stop whining ..

Posted: Wednesday, September 11, 2013
Article comment by: Bob Norris

@ Cliff,

I work in the insurance industry and know first hand that auto insurance rates are indeed lower now than they were 30 years ago when it was optional. I have the dec pages to prove it! There is a lot more competition for those premiums that would have otherwise never existed. It could be that you are paying too much???

It's not middle men that dramatically influence the costs (they do add some, just like any other liability). However, the demand for medical care is absolute, making it and the equipment very expensive. The second factor is the uninsured patients, who are cost shifted to those who do pay. Charity is nice, but this issue is too big for that. You have people with million dollar hospital bills, do you really think a charity organization around here can cover that?

So here is a scenario for you: Someone gets in an auto accident and is rushed to the hospital. In your world, everyone must pay there share or get charity. Therefore, a thorough check of their financial and insurance status would be mandatory before the rendering of medical care.

If they failed to have the money or insurance, they would be escorted out or referred to a local charity hospital five miles away! This is the only way it would work using your logic. You are right though, it would prevent cost shifting and paying for the uninsured.


Posted: Wednesday, September 11, 2013
Article comment by: Cliff Foster

>The Affordable Care Act will start penalizing individuals and families without health insurance $95 a person, up to a maximum of three people, in 2014, he said. That penalty will increase incrementally to $695 per person in 2016. Everyone up to 400 percent of the federal poverty level will be eligible for federal subsides to purchase health insurance.

In the 1980s legislators claimed that mandatory auto insurance would lower the cost of insurance for everybody. Check your rates today, they were wrong then, and now you're stuck with the law.

The reason medical prices are high is because of middle men. Why do the costs for uninsured plastic surgery plunge every year while and insured ambulance ride can cost upwards of $20,000? Administrators like Mr. Turney afford their tooth whitening by wedging themselves between you and your doctors.

Doctor. Patient. Cash.

Everything else, whether HMO, PPO, or ObamaCare, is a shell game intended to insert more middle men between patient and caregiver.

For those that cannot afford a doctor and are in duress, seek charity hospitals. When recovered, be charitable and donate to said charity hospital. If said charity hospital does not exist, work with your local church or spiritual body to institute one. Solve the problem locally.


Posted: Wednesday, September 11, 2013
Article comment by: One Question

In your reimbursement scenario the private insurance payers are not factored. What percentage do they pay? 60% Medicare that is incredible. Must mean most of our population is older or disabled. No wonder we have workforce issues. Would be interesting information to know what the Medicare average is elsewhere.



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