The Schleicher County Hospital District board of trustees met Monday evening, April 29th, where they heard an update on recent Medicare changes.
Andy Freeman and Larry Stephens, representing Preferred Management, were in attendance and outlined for the board several differences in traditional Medicare coverage and a plan called Medicare Advantage.
explained that the term Medicare Advantage refers to a wide array of insurance plans, marketed by private companies, and offering different levels of protection. He said that the name Medicare Advantage is confusing and added that the various plans represent a blend or hybrid of a Preferred Provider Organization (PPO), a Health Maintenance Organization (HMO), and conventional health insurance.
For his part, Freeman explained that a number of facilities, including the Ballinger hospital, are refusing to accept Medicare Advantage plans.
“We haven’t reached that point yet,” Freeman said, “but we want the board to be aware of the situation.”
Freeman went on to note that Medicare Advantage plans not only fail to reimburse providers for their cost of providing service, they can also restrict coverage that patients are accustomed to having.
“For example, some plans have limits that are lower than conventional Medicare and can require large out-of-pocket payments on the part of patients,” Freeman said.
He went on to note that some plans restrict or limit the access to “swing bed” days, requiring patients to spend hundreds if not thousands of dollars that would otherwise have been paid by conventional Medicare.
Freeman said that his purpose was to inform the board that his company, which operates the local hospital and clinic, as well as several others in Texas and Oklahoma, is seeing an uptick in the number of Medicare Advantage customers. He also advised that the reimbursement to the hospitals under the various plans falls short of compensating the facilities for the care they provide.
Freeman also noted that any decline in Medicare reimbursement would represent a decrease in the amount of revenue that could be used to help the district repay its bonded indebtedness.
“What you are saying is that Medicare Advantage is not advantageous for rural hospitals?” board president Randy Mankin asked.
“Exactly,” Freeman responded. “We just want you to know about the situation and help us educate the public about the differences. Conventional Medicare works best for rural patients and for rural facilities.”
Freeman and Stephens went on to note that the number of clinic visits are increasing and credited some of the increase to the arrival of Dr. Selina Burt. They further advised the board of a health care trustee conference slated for June in Fort Worth.
In other business the board reviewed the overall construction project and Mankin explained that inspectors from the Texas Department of Aging and Disability Services are due for a follow-up inspection of the nursing home on or before May 15th.
Discussion turned to completing the landscaping at the new facility with the possible installation of lighting along the curved driveway at the main entrance. It was also agreed that the district will offer for sale the pink stucco house located in front of the new medical center. The house is constructed on pier and beam and can be moved. However a front porch and a back “mud room” are built on concrete slabs and will have to be demolished and removed.
Mankin explained that the house will be advertised for sale by sealed bids as soon as it is no longer needed as a construction office.
efore adjourning, the board reviewed and approved the minutes of the previous meeting as well as the district’s financial reports. Several policy and procedure manuals were also approved.
It was also noted at the meeting that Nursing Home Administrator had recently completed her masters degree and she advised that she will begin working on a doctorate.
Monday night’s meeting was held in the board room of the new Schleicher County Hospital on North U.S. Highway 277 with trustees George Arispe, Denese Crowder, T.J. Rodriguez, Madolyn Phillips, Susie Richters and Randy Mankin in attendance. Trustee Jason Chatham was absent.