Outstate providers bail out of state's safety-net program, GAMC
St. Mary's Medical Center's decision not to participate in the new General Assistance Medical Care program for the state's poorest population leaves the program with no provider in St. Louis County and much of Northeastern Minnesota.
"Asking us to be the only provider in the county subjected us to essentially unlimited financial risk," said Dr. Tom Patnoe, SMDC president and chief medical officer.
They're not alone.
All other outstate "safety net" hospitals that were expected to provide care have also opted out, saying they can't afford it, including Mercy Hospital and Health Care Center in Moose Lake and North Country Health Services in Bemidji, said Rep. Tom Huntley, DFL-Duluth.
That leaves all of nonmetro Minnesota without providers in the program.
"That means the compromise the governor forced on us is not going to work," Huntley said. "I don't think it will work in the metro area. It's certainly not going to work in the rest of the state."
A health care-spokeswoman for the Minnesota Department of Human Services couldn't be reached for comment on Monday.
Of the 17 designated provider hospitals around the state, only four so far are participating, all in the Twin Cities area: Regions Hospital in St. Paul, North Memorial Medical Center in Robbinsdale, Hennepin County Medical Center in Minneapolis and University of Minnesota Medical Center, Fairview, in Minneapolis, Huntley said. A fifth hospital, Fairview Ridges in Burnsville -- is also participating, according to the Star Tribune.
The new GAMC program, which begins June 1, was a compromise between legislators and Gov. Tim Pawlenty to save the state-run health-care program for about 30,000 unemployed, indigent and homeless Minnesotans. Last year, Pawlenty cut the program's funding in a line-item veto.
But with the restored GAMC program funded at $164 million, less than one-third its previous level, provider hospitals are expected to absorb the cost of care that will likely far exceed the compensation.
Patnoe said the state provided $20 million to the region last year, which was disbursed to those providing care. "Everybody in the region did their fair share," he said. The allotment was reduced to $2 million with the revamped program.
Under the new plan, St. Mary's Medical Center in Duluth would have been the sole provider in Northeastern Minnesota, and if a GAMC patient got treatment at another hospital in the region, St. Mary's would have had to compensate that hospital for the costs.
"I don't know if anyone was satisfied with it before, but it was a more just and sustainable process before," Patnoe said. "The process they came up with was not very just and sustainable."
Moreover, the plan limited access for patients who can least afford to travel for health care, he noted.
The GAMC population -- who include mentally ill, chemically dependent and chronically ill adults -- still can be treated in hospital emergency rooms where, by law, they can't be turned way.
"The question is whether this is the best way to take care of them," Huntley said.
With emergency-room care among the most expensive types of health care, St. Mary's Medical Center and other hospitals are looking for ways to provide GAMC patients with less costly primary care in clinic-type settings, even if they're not compensated for it.
Some see hope in federal health-care reform that would allow states, including Minnesota, to expand medical assistance to adults without children.
"If that happens, the federal government would pay 50 percent of the cost," Huntley said.