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Government reimbursement a concern for W.Va. health officials

December 07, 2005|by TRISH RUDDER

trishr@herald-mail.com

MARTINSBURG, W.Va. - Reimbursment for patients who are in government health plans such as Medicaid and attracting more health-care professionals to West Virginia were among the topics discussed recently at the West Virginia Hospital Association's legislative advocacy briefing.

About 30 people, including Eastern Panhandle senators and delegates, attended the briefing, which covered key issues on the association's legislative agenda for the 2006 session, said Roger Eitelman, president and chief executive officer of West Virginia University Hospitals-East.

The need for adequate reimbursement from governmental payers was one major topic of discussion Thursday night. Almost 70 percent of patients in West Virginia hospitals are in a government health plan such as Medicaid, and government payers reimburse well below the cost of providing care for these patients, Eitelman said.

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Eitelman said another of West Virginia's biggest challenges is the 270,000 residents without medical insurance.

Jon Applebaum, senior vice president and chief operating officer for WVU Hospitals-East, said West Virginia has a greater dependency on government funding. He said 70 percent of total revenues come from governmental payers, while the national average is 60 percent.

Applebaum said because of funding shortfall issues, West Virginia hospitals lost more than $55 million caring for Medicaid patients in 2004.

Applebaum said when Gov. Joe Manchin III came into office, he wanted to restructure the Medicaid program, and West Virginia's Medicaid redesign proposal should be ready for implementation by July 2006.

He said a draft proposal is being reviewed by the West Virginia Department of Health and Human Resources.

Applebaum said prevention and personal responsibility are part of the redesign proposal, and also said the long-term redesign proposal must include the at-risk population - the aged, blind, disabled, infants and pregnant women.

John Borg, the administrator for War Memorial Hospital in Berkeley Springs, said West Virginia needs more health-care professionals.

One of the problems is the salary difference in competing states. A registered nurse in West Virginia is paid $42,000 per year, but can make $49,000 in Virginia and $63,000 in Maryland, he said.

"Our number one export is not coal or timber, it's our children," said state Sen. John Unger, D-Berkeley/Jefferson.

Teresa McCabe, the vice president of marketing and development for WVU Hospitals-East, said meetings with legislators have been held all over the state over the last few months.

WVU Hospitals-East represents City Hospital in Martinsburg and Jefferson Memorial Hospital in Ranson, W.Va.

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