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Virginia Gay Hospital and Clinics have improved the quality of care and the scope of services offered to patients. Medical decisions affecting care patients are made here, by our medical providers without interference from administrators unfamiliar with the needs of small communities and the professional skills that local, dedicated physicians, physician assistants, and nursing staff use to the benefit of their patients. Now the financial stability of small community hospitals, the quality of care provided to the elderly and those without the means to pay for their care, is being threatened by changes to Iowa's Medicaid program. Medicaid pays for the care of children with profound disabilities; care only the wealthiest family could afford without assistance. Of the elderly in nursing homes, about 60% rely on Medicaid because they are without resources, or their savings and assets have already been spent to pay for their care. Those who are disabled and unable to work rely on Medicaid, including many who are blind, deaf, or suffer from a mental illness. Before putting management of Iowa's Medicaid program into the hands of private companies, the State of Iowa administered payments and benefits. The Iowa program was one of the best in the U.S. for cost-containment and quality of care. When Governor Branstad put private companies in charge, it was the first time any state put its entire program completely under the control of private companies in one step. Most states using private companies still oversee some of their programs helping especially vulnerable patient populations. Rob Gardner, CEO of Henry County Health Center in Mount Pleasant, recently testified before the Senate committee responsible for the transition of Iowa's Medicaid system to management by private corporations. He shared with senators that the reduction in Henry County Health Center income in 2017, because of the changes to Medicaid, amounted to almost $1 million. Virginia Gay income also declined because of the changes, and though difficult to quantify with precision, the range is between $400,000 and $700,000. As reported by the Iowa Hospital Association, Gardner told senators, ""the average Critical Access Hospital has a negative operating margin, (and) the margins are getting thinner." The IHA information also noted that Senator Amanda Ragan (D-Mason City) remarked that even as providers are struggling under the new system, the state recently agreed to increase payments to the companies managing Iowa's Medicaid program by an average 3.3 percent per patient. Medicaid was created to protect individuals and families from suffering because they couldn't afford essential health care services. One way it did so was to protect hospitals, nursing homes, and healthcare professionals from financial disaster caused as a result of caring for Iowa's most vulnerable patients. Iowa's hospital administrators and health care providers are concerned that actions by the state of Iowa are unraveling those protections and that we will soon be forced to choose - between going broke or denying care to those with the greatest need. To learn more about pending changes to Iowa's Medicaid program and to participate in the debate as a concerned citizen, visit the Iowa Hospital Association online.


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