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Saving rural Colorado hospitals
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By Joshua Pilkington

The legislature looks for ways to save hospitals and communities in rural Colorado

Finding bipartisan support for significant legislation is difficult these days and, in Colorado, has been difficult for decades. One bill, however, is gaining traction as it becomes increasingly clear that Colorado’s rural hospitals are in need of assistance.

The “Sustainability of Rural Colorado” bill is a rare piece of significant bipartisan legislation that has co-sponsorship from Republican and Democrat state legislators alike. Senate Minority Leader Lucia Guzman (D-District 34), Senator Jerry Sonnenberg (R-District 1), House Majority Leader KC Becker (D-District 13) and house representative Jon Becker (R-District 65) are all co-sponsoring the bill, which calls for an accounting shift involving the Hospital Provider Fee in order to rescue about half a billion dollars in funding for hospitals.

Implemented under the Colorado Health Care Affordability Act and according to the same, the Hospital Provider Fee “authorizes the Department of Health Care Policy and Financing to collect a hospital provider fee to increase Medicaid payments to hospitals, fund hospital quality incentive payments, expand health care coverage to programs like CHP-plus and reduce cost-shifting to private payers.”

The Colorado Department of Health Care Policy and Financing reports that since its implementation in 2010 the fee has “increased hospital reimbursement by $1.4 billion with no General Fund expenditure.”’

The problem with the fee currently isn’t the money it’s generating, it’s where the money is going. Since the Hospital Provider Fee was set up under the voter-approved spending limits of the Taxpayer Bill of Rights (TABOR), it is factored into the state budget, making it another piece of a budget-balancing puzzle.

According to Colorado Public Radio, those budget-balancing tricks have resulted “in a double-hit to hospitals, because they also lose an equivalent amount of federal matching dollars.”

In other words, not only are the hospitals susceptible to TABOR revenue limits, they are also not receiving the full amount of matching federal dollars they would otherwise be entitled to. Through “Sustainability of Rural Colorado” the Hospital Provider Fee would no longer fall under TABOR revenue limits allowing for an estimated $700 million to go toward rural roads and school districts while keeping Colorado’s decaying rural hospitals open.

According to the Colorado Rural Health Center, of the 35 hospitals found in rural Colorado, 12 are in danger of closing and some of those closings could affect Southern Colorado, as well.

With 650 employees the San Luis Valley Health regional medical center in Alamosa is the largest employer in the San Luis Valley region. With state budget cuts looming, the medical center could see losses of upwards of $4 million dollars. Though that may not spell the medical center’s doom as it would in other rural hospitals, it is certainly a cause for alarm and a reason for fiscal change. Governor John Hickenlooper has pointed out publicly that the proposal for deep cuts to the state’s hospitals is real and he hopes it will serve as a wake up call to legislators to take action against their self-imposed government financing stalemate.

Though the “Sustainability of Rural Colorado” bill has bipartisan support, it is not a knockout for everyone. Linda Gorman, Director of Health Care Policy at the Independence Institute, has spoken out against the bill saying that it continues to rely on matching federal Medicaid funding. Those with an eye and ear on the Trump administration know that matching federal funding for Medicaid is no longer a sound financial approach to any health-care related topic.

Regardless of where the funding comes from, the state legislature on both sides of the aisle have large, looming decisions to make when it comes to the rural sector of the state.





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