Payment is major obstacle in trauma negotiations

August 17, 2002|by SCOTT BUTKI

Washington County Hospital officials hope a meeting in Annapolis next week to discuss the hospital trauma center will help resolve a problem related to uninsured patients, hospital spokeswoman Maureen Theriault said Friday.

The meeting was called by Maryland House Speaker Casper R. Taylor to find a way to reopen the hospital's trauma center, which suspended operations June 1.

One of the sticking points in discussions between the hospital administration and trauma surgeons is how physicians can be reimbursed for treating patients who can't pay for emergency medical care.


State law prohibits hospitals from turning away people who need medical attention even if they can't afford to pay for it, said Del. John P. Donoghue, D-Washington, who is on the Washington County Hospital Trauma Center Task Force.

About 20 percent of Washington County trauma center patients can't pay for medical services because they do not have insurance, Theriault said.

Out of 64,000 people taken to the hospital emergency room last year, 744 received trauma care, hospital officials have said. Of those, about 250 were treated and released.

The hospital administration hopes a way can be found for physicians to be paid for their services when patients can't pay their bills, Theriault said. The administration is not recommending whether that money should come from the government, insurance companies or another source, she said.

Donoghue co-sponsored state legislation that was adopted this year asking state commissions to explore the issue.

A second sticking point is that trauma center surgeons are financially limited by their obligation to be available exclusively for trauma patients.

When the surgeons are on call at the hospital, they are not supposed to treat nontrauma patients or perform elective surgery even if there are no trauma patients, said Mary Beachley, director of the Office of Hospital Programs for the Maryland Institute of Emergency Medical Services System and a trauma center task force member.

As a result, the physicians do not generate the income they would if they were seeing regular patients.

To make up for that, the hospital reimburses the trauma surgeons at a set rate for each hour they are at the hospital, Theriault said. She would not reveal that rate.

The hospital paid about $1 million last year to trauma surgeons and administrators, said Deborah Addo, vice president for hospital patient care services and a task force member.

Separately, physicians charge patients or their insurance companies for services provided, Theriault said.

Last year it cost about $6.2 million a year to run the trauma center, a spokeswoman said. The hospital has been subsidizing the trauma center's operation by about $1.9 million a year, hospital officials have said.

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