MANATEE -- The county has proposed a $1.2 million cut in indigent health care for Manatee Memorial Hospital this year, putting the onus for those costs on the hospital if the new contract is approved.
Kevin DiLallo, chief executive officer of Manatee Memorial, said his hospital will come up more than $2 million short for indigent care if the proposed cut is adopted.
According to preliminary figures, Manatee County is preparing to offer the Manatee Healthcare System, which operates Manatee Memorial Hospital, a contract of $3.525 million to treat indigent patients from Oct. 1, 2015, through Sept. 30, 2016, said Karen Windon, deputy county administrator.
Blake Medical Center would get a $500,000 contract, Windon said. Blake received $670,000 last year.
The numbers are still being fined-tuned and not yet approved, she added.
Dan J. Friedrich, chief executive officer of Blake Medical, also is concerned about the proposed health care contract delivered to his hospital.
"It is lower than last year's rate and it includes some conditions of participation that were not a part of previous contracts," Friedrich said.
The upcoming contracts, said Windon, have new requirements to "build a system of care."
"For example, there will be language regarding data access, utilization of a common health information exchange and ongoing partner or stakeholder meetings to ensure we look holistically at that system of care," Windon said.
DiLallo said Manatee Memorial Hospital spent $5.6 million on indigent health care last fiscal year and only received $4.7 million from the county to cover those costs.
Those hospitals served more than 2,000 impoverished patients in the past year.
DiLallo said expanded Medicaid coverage, which the state turned down, may have helped filled some of the funding gaps but "Florida would still have a fair amount of patients that ... would not qualify."
"We know from county audits and past history that the care that was provided cost MMH $5.6 million and we received reimbursement of $4.7 million," DiLallo said. "To be given a contract for $3.5 million creates an obvious problem for the delivery of health care in our county. We need better solutions than just to divide a number and make sure everyone gets a share."
Windon said the preliminary figures came after a lot of consideration and study.
"We tried to make a reduction for each of the hospitals that was a consistent percentage decrease," Windon said. "We looked at the total amount of funding that was put in reserves this fiscal year to allocate toward health care and at the services our medical partners were able to provide."
The county helped serve 2,018 indigent patients last year, Windon said.
If the cut to Blake stays, it will not alter Blake's approach to indigent care, Friedrich said.
"This will not change the way we treat patients or the services that we offer to all members of our community," Friedrich said.
While DiLallo said they don't plan to make any cuts to service, he would rather have full reimbursements.
"MMH will provide the appropriate care that is needed for our patients. It's not a question of what do you cut," he said, "it should be a question of how much does it cost and that we get reimbursed the proper amount."
Other counties have figured it out and have put in sustainable and progressive programs, DiLallo added.
"I wish we were not put in this position of being asked what we need to cut," DiLallo said. "The better position would be how can we make the program more advanced and provide the best medical care to our patients."
The scramble to fund the hospitals for treating indigent patients is occurring because the fund covering indigent care dried up and the last contract that ran through Sept. 30 was not renewed.
So, for the first time in 30 years, Manatee County still has no contract with a hospital to provide care for its indigent population, Windon said.
While the hospitals are taking reimbursement cuts, the indigent health care proposal calls for payments to physicians for indigent care to rise slightly from $1 million to $1.25 million, Windon said.
DiLallo and Friedrich support the increase.
"As the number of indigent patients in our area grows, it is appropriate for all providers to receive an increase in payments," Friedrich said.
"Our doctors work hard and do a great job," DiLallo said. "They deserve an increase."
Without doctors willing to help, there would be no indigent care plan, DiLallo added.
Richard Dymond, Herald health/social services reporter, can be reached at 941-745-7072. Follow him on Twitter@RichardDymond.