Question on heart care facilities in MS …

[DAWGSANDSAINTS]

I know OCH doesn’t have a Cath Lab so why take Coach Leach there when Columbus does?
What they probably did in the ambulance on the way to OCH they could have done on the way to Columbus.
It’s not that much further and I’m not sure how they could have gotten him stable enough for transport to JXN?
I’m not a interventional cardiologist obviously and don’t know all the details obviously, just thinking about what all happened and decisions that were made in an emergency situation.
Edited to add that I’ve seen people say St Dominic is the preferred heart hospital in Jxn so why not go there ?

 

[Xenomorph]

I’m not usually one to judge what should and should not be hypothesized and discussed on a message board… but let’s not do this.

 

[Called3rdstrikedawg]

My sister had a massive heart attack sitting in her chair drinking coffee while he grandson was still asleep on the couch in front of her. She had no chance. The fact that Coach is still holding on is a miracle. No need to speculate on this or that woulda, shoulda, coulda. If he pulls through it will be because he got EMT treatment.

 

[theoriginalSALTYdog]

I know OCH doesn’t have a Cath Lab so why take Coach Leach there when Columbus does?
What they probably did in the ambulance on the way to OCH they could have done on the way to Columbus.
It’s not that much further and I’m not sure how they could have gotten him stable enough for transport to JXN?
I’m not a interventional cardiologist obviously and don’t know all the details obviously, just thinking about what all happened and decisions that were made in an emergency situation.
Edited to add that I’ve seen people say St Dominic is the preferred heart hospital in Jxn so why not go there ?

None of that really matters honestly. Truth is after 5 mins w/o oxygen you have brain damage. 8 mins w/o oxygen and your brain is essentially dead. That's the case here.

 

[karlchilders.sixpack]

I know OCH doesn’t have a Cath Lab so why take Coach Leach there when Columbus does?
What they probably did in the ambulance on the way to OCH they could have done on the way to Columbus.
It’s not that much further and I’m not sure how they could have gotten him stable enough for transport to JXN?
I’m not a interventional cardiologist obviously and don’t know all the details obviously, just thinking about what all happened and decisions that were made in an emergency situation.
Edited to add that I’ve seen people say St Dominic is the preferred heart hospital in Jxn so why not go there ?

We recently went thru this with my sister. It came down, to what service was needed. AND, which hospital
had space available, that could accommodate.
That generally included Tupelo, Oxford, Columbus, Jackson, or Memphis.
This was several times, over almost 18 months.

 

[DAWGSANDSAINTS]

I’m not trying to blame anyone or any medical facility/personnel nor would I.
But I do think it’s legitimate questions and I’m curious as to the answers and about what prompted the decisions made and I think that may be asked later.
I think anyone would be curious but I also know no one one this board knows the answers to these questions.
I also know nothing about the healthcare facilities in Starkville, Columbus or Jackson other than Starkville does not have a Cath Lab.
They should however.

 

[PirateBay]

I think the bigger issue is response time. If it’s a very critical emergency, you’re probably getting a life flight to Jackson or Tupelo. But, generally speaking, the window between the event and getting help is the most critical.

Overall, if you want to see MS healthcare improve, push elected officials about Medicaid expansion. I know thats a party line topic for some, I don’t care, our healthcare is suffering and that means people are suffering.

 

[L4Dawg]

This may or may not had anything to do with it, but hospital ICUs in Mississippi are as full as they were at the height of the waves of the pandemic. It's lots of respiratory stuff right now. Some hospitals can't take any new patient transfers at times.

 

[MSUGUY]

I think the bigger issue is response time. If it’s a very critical emergency, you’re probably getting a life flight to Jackson or Tupelo. But, generally speaking, the window between the event and getting help is the most critical.

Overall, if you want to see MS healthcare improve, push elected officials about Medicaid expansion. I know thats a party line topic for some, I don’t care, our healthcare is suffering and that means people are suffering.

No

 

[drexeldog23]

I know OCH doesn’t have a Cath Lab so why take Coach Leach there when Columbus does?
What they probably did in the ambulance on the way to OCH they could have done on the way to Columbus.
It’s not that much further and I’m not sure how they could have gotten him stable enough for transport to JXN?
I’m not a interventional cardiologist obviously and don’t know all the details obviously, just thinking about what all happened and decisions that were made in an emergency situation.
Edited to add that I’ve seen people say St Dominic is the preferred heart hospital in Jxn so why not go there ?

Baptist Hospital is a great heart hospital. my mom had open heart surgery there in 2008. she lived until 2020 and she did not die of anything heart related.

 

[HailStout]

I know OCH doesn’t have a Cath Lab so why take Coach Leach there when Columbus does?
What they probably did in the ambulance on the way to OCH they could have done on the way to Columbus.
It’s not that much further and I’m not sure how they could have gotten him stable enough for transport to JXN?
I’m not a interventional cardiologist obviously and don’t know all the details obviously, just thinking about what all happened and decisions that were made in an emergency situation.
Edited to add that I’ve seen people say St Dominic is the preferred heart hospital in Jxn so why not go there ?

Sudden cardiac arrest has a horrendous prognosis. Something like 5 to 8 percent of patients survive to hospital discharge. That doesn’t take into account whatever deficits they leave with. As far as the cardiac cath goes, there are specific guidelines for how long from the event you get someone to cath lab. There are also contraindications for taking someone to cath lab, such as their pH. Frequently people are literally too sick to go to cath lab and doing a cath can actually cause an arrhythmia and put them back in cardiac arrest. If you are in the middle of nowhere and they can’t get you to a cath lab in time and (if it is indicated) they may push TPA (clot buster). There are also certain heart attacks you don’t cath immediately by definition. The message here is it is probably not as straight forward as it is being painted and there are zero indications at this point that Leach didn’t receive the utmost in care.

 

[patdog]

Sudden cardiac arrest has a horrendous prognosis. Something like 5 to 8 percent of patients survive to hospital discharge. That doesn’t take into account whatever deficits they leave with. As far as the cardiac cath goes, there are specific guidelines for how long from the event you get someone to cath lab. There are also contraindications for taking someone to cath lab, such as their pH. Frequently people are literally too sick to go to cath lab and doing a cath can actually cause an arrhythmia and put them back in cardiac arrest. If you are in the middle of nowhere and they can’t get you to a cath lab in time and (if it is indicated) they may push TPA (clot buster). There are also certain heart attacks you don’t cath immediately by definition. The message here is it is probably not as straight forward as it is being painted and there are zero indications at this point that Leach didn’t receive the utmost in care.

We don’t know the situation at the time. But we do know the EMTs know more about this than we do. I’m sure they took him to the place they thought was best.

 

[Nicephorus123]

I’m not trying to blame anyone or any medical facility/personnel nor would I.
But I do think it’s legitimate questions and I’m curious as to the answers and about what prompted the decisions made and I think that may be asked later.
I think anyone would be curious but I also know no one one this board knows the answers to these questions.
I also know nothing about the healthcare facilities in Starkville, Columbus or Jackson other than Starkville does not have a Cath Lab.
They should however.

As long as OCH is county owned, unlikely they ever get any advanced emergent services like 24/7 cardiac cath lab coverage. OCH would need a lot larger referral base to generate the revenue to support and staff something like that which is unlikely given they’re based in a single county.

 

[LordMcBuckethead]

I think the bigger issue is response time. If it’s a very critical emergency, you’re probably getting a life flight to Jackson or Tupelo. But, generally speaking, the window between the event and getting help is the most critical.

Overall, if you want to see MS healthcare improve, push elected officials about Medicaid expansion. I know thats a party line topic for some, I don’t care, our healthcare is suffering and that means people are suffering.

OCH had a chance to be bought out by Baptist. If that would have happened, Baptist would have had better overall care, and guess what, the county would not have had to pay to upgrade the facilities anymore. Also, they would be a tax payer instead of a tax sink hole.

I don’t know if a Baptist place that doesn’t have a cardiologist and neuro on staff. Ours does not, to my knowledge. Luckily heart disease and stroke are not leading causes of death in Mississippi.

 

[LordMcBuckethead]

As long as OCH is county owned, unlikely they ever get any advanced emergent services like 24/7 cardiac cath lab coverage. OCH would need a lot larger referral base to generate the revenue to support and staff something like that which is unlikely given they’re based in a single county.

Yep. People that voted to keep OCH on the county payroll were woefully misinformed on the breath of the gigantic issue we have and the opportunities to better serve our community we unfortunately have missed out on.
Oxford l, in the same period of time have recieved 150 million dollars worth of upgrades in their hospital by Baptist.

 

[Oxford1952]

Perhaps the amazing thing about this case is that the ambulance on arrival was able to get him back into a rhythm with shocks after being without oxygen for an unknown period of time. I heard he was alone at the time of his event, and no one knows just how long he had been arrested. But it was 10-15 mins before the ambulance arrived to revive him.
Just an unfortunate and sad situation.

 

[Beretta.sixpack]

I think the bigger issue is response time. If it’s a very critical emergency, you’re probably getting a life flight to Jackson or Tupelo. But, generally speaking, the window between the event and getting help is the most critical.

Overall, if you want to see MS healthcare improve, push elected officials about Medicaid expansion. I know thats a party line topic for some, I don’t care, our healthcare is suffering and that means people are suffering.

for several years i was completely against medicaid expansion in our state.....its time....we are a rural state and our rural hospitals are on the verge of shutting down....the country is down to 8 states without the expansion, us being one....i think we have a blue print of what not to do, which is what our state does so well....watch, be the last to do something, and perfect it....its time...if we start losing our small town hospitals, the feds are going to step in ....and no one wants to see that on the evening news...

 

[YungDispo]

The biggest predictor of good neurologic outcome in cardiac arrest is bystander CPR and early defibrillation. The best chance he had at survival was most likely ECMO, which, as far as I know, only UMMC has the resources and staff to perform in the state.

 

[tribaldawg]

Every ambulance service in the country would have transported Leach to the closest facility to be stabilized and transferred. You have one paramedic in the back of the truck versus a full team of doctors, nurses, respiratory therapists, X-ray techs, etc., plus a CT machine, a ventilator, etc. There is absolutely no question the ambulance guys did an outstanding job and made the only transport decision that was appropriate. Excellent work by the OCH EMS team. BTW, Baptist in Columbus would have stabilized him in their ER and flown him out just like OCH did. You have no idea how many cardiac patients are transferred from BMH-GT to Tupelo, UAB, or UMC every week.

 

[tribaldawg]

BTW, the EMS call to Coach Leach’s house is a common call for an EMS crew. The emotions we all have shared over the last few days are routinely experienced by EMS crews but the names of their patients aren’t nearly as known as Coach Leach. Instead of questioning the great work they do just realize what they go through on a regular basis and pat them on the back and buy them lunch if you have an extra couple of bucks.

 

[cling84]

All four of the major hospitals in Jackson (UMMC, Baptist, St Dominics, Merit) all have a great cardiac staff. I suppose Coach Leach was taken to UMMC because they are the only critical care (Level 1) trauma center in the state. Tupelo is Level 2. A friend of mine who once worked at MSU got into a car accident just north of Starkville. She was taken to OCH, stabilized, then also flown to UMMC. Also possible since he is a state employee he is covered by the state employee insurance plan.

 

[GloryDawg]

The biggest predictor of good neurologic outcome in cardiac arrest is bystander CPR and early defibrillation. The best chance he had at survival was most likely ECMO, which, as far as I know, only UMMC has the resources and staff to perform in the state.

4 years ago My mom had some serious heart problem. When the ambulance picked her up, she said take her to River Oaks in Flowood. She was out of it mentally and she just remembered having surgery there one time. We got there and it did not look good. The hospital would only do certain things because they thought all she had was Medicare. She had a major medical along with it. I argued with the doctor, the social worker, the nurses do more because of the insurance. They thought the United Health Care was a Medicare supplement. Once I got them convince enough to check, they went to work. She survives.

My mother has dementia now and my dumbass brother convince everyone she needed hospice. I did not know it was hospice. I was told it was home health. They knew I would be pissed because mom was not terminal. One day about seven weeks ago she woke up and could not walk. The hospice nurse said it was the Demetia. About five weeks ago she was out and unresponsive. The hospice nurse said it was Demetia and she did not have long. My dumbass brother said just let her die at home. I was up there on a Friday, and I did not like that idea. I woke up Saturday and called an ambulance. I told my brother he could kiss my *** I am getting mom off hospice and putting her in the hospital to give her a chance. I had them take her to UMC. They went to work on her. They were like the 101st Airborne on D Day. No question they just went to work. The doctor and two interns came in and the first thing I told them was she has a major medical. The doctor told me they did not care if she had insurance or not. They were going to use every machine, tools whatever they had available, and we would worry about the money on the back end. Just opposite of River Oaks.

Turns out she had a UTI infection. Two days later she was talking and knew where and who she was. That first night I got a call from the doctor at 1:30 A.M wanting to do an MRI. The scan showed she had a stroke in the past. My mom had some hardware in her heart. They needed to know if it was MRI compatible. I told the doctor you scared the hell out of me calling 1:30 in the morning. He said we never shut down. We work 24/7. We learned when she lost her ability to walk it was because of a stroke.

I believe in UMC. You are going to get the best care regardless of who you are.

My mom is at home. She is getting PT at home. She will never walk again but she and I watched the Egg Bowl together and she was sitting in her recliner. I have not gotten past what all happened. I am still piss at my brother. She would be dead now if I had not spoken up.

 

[squintdawg]

I know OCH doesn’t have a Cath Lab so why take Coach Leach there when Columbus does?
What they probably did in the ambulance on the way to OCH they could have done on the way to Columbus.
It’s not that much further and I’m not sure how they could have gotten him stable enough for transport to JXN?
I’m not a interventional cardiologist obviously and don’t know all the details obviously, just thinking about what all happened and decisions that were made in an emergency situation.
Edited to add that I’ve seen people say St Dominic is the preferred heart hospital in Jxn so why not go there ?

So - there are a lot of factors. First, if you have a patient like Coach Leach, he needs to go to a facility that not only has a Cath lab, but a cardiac surgical program. While Columbus has a CV surgical program, when you are transporting them, at that point, take them somewhere who can handle much more complex cases. Someone mentioned going to UMC because it being a Level I Trauma center, well that has no real factor in this situation. It is honestly likely because they have a clinical relationship with OCH. In terms of the Jackson Hospitals - this is something either UMC, St. D or Baptist could all handle. My personal opinion is that the MD's at Baptist are better now (20 years ago I would have said St. D). That all being said - the issue seems to be the time to the initial treatment. Just sad all the way around. Pray for him, his family and his football team!!!!

 

[squintdawg]

All four of the major hospitals in Jackson (UMMC, Baptist, St Dominics, Merit) all have a great cardiac staff. I suppose Coach Leach was taken to UMMC because they are the only critical care (Level 1) trauma center in the state. Tupelo is Level 2. A friend of mine who once worked at MSU got into a car accident just north of Starkville. She was taken to OCH, stabilized, then also flown to UMMC. Also possible since he is a state employee he is covered by the state employee insurance plan.

I would not put Merit in that group. River Oaks does not have in Interventional Cath Lab, but not the surgical capabilities. Not the same level of MDs.

 

[squintdawg]

I think the bigger issue is response time. If it’s a very critical emergency, you’re probably getting a life flight to Jackson or Tupelo. But, generally speaking, the window between the event and getting help is the most critical.

Overall, if you want to see MS healthcare improve, push elected officials about Medicaid expansion. I know thats a party line topic for some, I don’t care, our healthcare is suffering and that means people are suffering.

Mississippi's failure to expand Medicaid has a direct impact on the care, especially in Rural Areas. Those hospitals struggle much much more. It is a shame too. Our leaders will mortgage our future to attract good paying jobs to communities and not realize the economic destruction that happens when a local hospital fails. Not saying we should backstop hospitals, but the economic impact of not expanding Medicaid is real and it has a real impact on the lives. All that said - no hospital like OCH would have ever really had the cardiac capabilities to treat a case like Coach Leach's. He would have had to be transferred regardless.

 

[L4Dawg]

Tupelo can handle nearly anything cardiac. Many outside the NE Mississippi area don't really know much about that hospital. It's huge, and has most specialties available. It's the largest hospital in the US in what's considered a rural area. It's also the largest single hospital in Mississippi by number of beds. If you are transferred from there you usually go to Memphis or UAB.

 

[UpTheMiddlex3Punt]

If the situation is like they're describing with him having gone who know how long before being found, it probably wouldn't have mattered if he had lived next to the Mayo Clinic.

But it's sad how rural hospitals have decayed over the last fifty years. It's a bigger issue for the people who are seen having heart attacks and have an ambulance called.

 

[grimedawg1]

No

The original poster is correct. Healthcare financing is complicated and refusal to expand Medicaid is a major reason MS hospitals are struggling. Hospitals can't afford to provide certain services and coverage if there is not a significant enough base to provide that coverage to. If a major portion of the population can't afford service, that makes the population base that can afford service smaller. So, whether you as an individual have insurance or not, the population base that has insurance may not be significant enough for the hospital to provide care beyond basic services. The nation more than 10 years ago determined that it is going to finance care in a certain way (elections matter). And, it is not going back. For political reasons, and not economic reasons, MS has not expanded. It's been a huge success in other states (paid primarily by the Federal government, again, it's not going to change going forward). The expanded population would be the working poor that cannot afford care. Why not give folks an incentive to work instead of an incentive to get their income as low as possible to try to qualify for medicaid if they are not healthy?

I don't want to continue a policy argument here. But, the issue is that there are folks all over our state that have medical emergencies and hospitals are having to reduce services or coverage because they lack the revenue to fund such. Lack of medicaid expansion is a big part of that.

 

[Ranchdawg]

4 years ago My mom had some serious heart problem. When the ambulance picked her up, she said take her to River Oaks in Flowood. She was out of it mentally and she just remembered having surgery there one time. We got there and it did not look good. The hospital would only do certain things because they thought all she had was Medicare. She had a major medical along with it. I argued with the doctor, the social worker, the nurses do more because of the insurance. They thought the United Health Care was a Medicare supplement. Once I got them convince enough to check, they went to work. She survives.

My mother has dementia now and my dumbass brother convince everyone she needed hospice. I did not know it was hospice. I was told it was home health. They knew I would be pissed because mom was not terminal. One day about seven weeks ago she woke up and could not walk. The hospice nurse said it was the Demetia. About five weeks ago she was out and unresponsive. The hospice nurse said it was Demetia and she did not have long. My dumbass brother said just let her die at home. I was up there on a Friday, and I did not like that idea. I woke up Saturday and called an ambulance. I told my brother he could kiss my *** I am getting mom off hospice and putting her in the hospital to give her a chance. I had them take her to UMC. They went to work on her. They were like the 101st Airborne on D Day. No question they just went to work. The doctor and two interns came in and the first thing I told them was she has a major medical. The doctor told me they did not care if she had insurance or not. They were going to use every machine, tools whatever they had available, and we would worry about the money on the back end. Just opposite of River Oaks.

Turns out she had a UTI infection. Two days later she was talking and knew where and who she was. That first night I got a call from the doctor at 1:30 A.M wanting to do an MRI. The scan showed she had a stroke in the past. My mom had some hardware in her heart. They needed to know if it was MRI compatible. I told the doctor you scared the hell out of me calling 1:30 in the morning. He said we never shut down. We work 24/7. We learned when she lost her ability to walk it was because of a stroke.

I believe in UMC. You are going to get the best care regardless of who you are.

My mom is at home. She is getting PT at home. She will never walk again but she and I watched the Egg Bowl together and she was sitting in her recliner. I have not gotten past what all happened. I am still piss at my brother. She would be dead now if I had not spoken up.

You are a good son! My mother went through a horrible situation at Aberdeen Hospital. She went in with pneumonia and they started fluids on her and antibiotics. She started getting better but they change doctors like we change clothes. They kept pumping her full of fluids because each doctor came in and order it. I got a call while at work that my mother was in failing health and that I better come see her if I wanted to before she passed. I jumped in the car and rushed to the hospital. When I went up to her floor the Respiratory Therapist was talking to the charge nurse and I told him to come with me. When I got to the room the dr. and nurse were standing there and they told me she was having a hard time breathing. She was gasping for breath and they had her elevated in the bed. I told the Respiratory Therapist to help her with her breathing. He immediately hooked up oxygen and put a mask on her. She was twice her normal size. They had pumped so much fluid into her that she was drowning. I told the respiratory therapist to stabilize her while I went and got transport set up to Tupelo Hospital. A couple of days later she was back to normal but had a heart issue that she didn't have before. My mother lives by herself, still drives and has all of her mental capacity. They treated her like an invalid while she was in Amory Hospital and almost killed her. I begged her not to go to Aberdeen Hospital but she wanted to because her doctor was in Aberdeen.
All this happened about 6 years ago and my mother is doing well except for the heart issue. I believe the fluids caused her to have a heart attack which damaged a portion of her heart. She is not on oxygen and still drives herself to church and to the doctor. I just wonder how many people have lost loved ones because of situations similar to what you and I have experienced with "health care" workers.

 

[L4Dawg]

The original poster is correct. Healthcare financing is complicated and refusal to expand Medicaid is a major reason MS hospitals are struggling. Hospitals can't afford to provide certain services and coverage if there is not a significant enough base to provide that coverage to. If a major portion of the population can't afford service, that makes the population base that can afford service smaller. So, whether you as an individual have insurance or not, the population base that has insurance may not be significant enough for the hospital to provide care beyond basic services. The nation more than 10 years ago determined that it is going to finance care in a certain way (elections matter). And, it is not going back. For political reasons, and not economic reasons, MS has not expanded. It's been a huge success in other states (paid primarily by the Federal government, again, it's not going to change going forward). The expanded population would be the working poor that cannot afford care. Why not give folks an incentive to work instead of an incentive to get their income as low as possible to try to qualify for medicaid if they are not healthy?

I don't want to continue a policy argument here. But, the issue is that there are folks all over our state that have medical emergencies and hospitals are having to reduce services or coverage because they lack the revenue to fund such. Lack of medicaid expansion is a big part of that.

I'm not up enough to know which would be better. I do know that Mississippi has been burned before by the Federal Government on this. They expanded it, or one of its programs, and then a few years later ended funding for it and the state had to pay more and cut benefits. It was a nightmare for the state. I think that has as much to do with Mississippi's stance as anything.

 

[MSUGUY]

The original poster is correct. Healthcare financing is complicated and refusal to expand Medicaid is a major reason MS hospitals are struggling. Hospitals can't afford to provide certain services and coverage if there is not a significant enough base to provide that coverage to. If a major portion of the population can't afford service, that makes the population base that can afford service smaller. So, whether you as an individual have insurance or not, the population base that has insurance may not be significant enough for the hospital to provide care beyond basic services. The nation more than 10 years ago determined that it is going to finance care in a certain way (elections matter). And, it is not going back. For political reasons, and not economic reasons, MS has not expanded. It's been a huge success in other states (paid primarily by the Federal government, again, it's not going to change going forward). The expanded population would be the working poor that cannot afford care. Why not give folks an incentive to work instead of an incentive to get their income as low as possible to try to qualify for medicaid if they are not healthy?

I don't want to continue a policy argument here. But, the issue is that there are folks all over our state that have medical emergencies and hospitals are having to reduce services or coverage because they lack the revenue to fund such. Lack of medicaid expansion is a big part of that.

Why is the critical access hospital in Ruleville thriving? There’s been no expansion of Medicaid there. Medicaid and Medicare have terribly low rates of reimbursement therefore increasing low money losing reimbursement will not help much. As a critical access hospital/area Ruleville benefits from increased Medicare and I assume higher Medicaid rates for providers. The issue as you said is we decided to insure a lot more people but the real issue is the insurance sucks if you are a provider or hospital. The government needs to raise payments. By the way Medicare and Medicaid have scheduled a 10% payments cut to providers(healthcare heroes) in 2023.

 

[grimedawg1]

I'm not up enough to know which would be better. I do know that Mississippi has been burned before by the Federal Government on this. They expanded it, or one of its programs, and then a few years later ended funding for it and the state had to pay more and cut benefits. It was a nightmare for the state. I think that has as much to do with Mississippi's stance as anything.

You should try to get to know about this issue. It is a huge issue. The federal government cutting off funding has been an excuse that has been used for 10 years. I am not aware of any sort of situation where the state was left hanging by the federal government. You'd need to be more specific because that just doesn't fly. It's not stopped the vast majority of states from going ahead and implementing it. And, to account for that, you simply have a sunset where if the fed government eliminated funding for that population, it sunsets. Meanwhile, about $1 billion in funding for the state has been forgone each year for more than 10 years. That's a big deal.

 

[L4Dawg]

You should try to get to know about this issue. It is a huge issue. The federal government cutting off funding has been an excuse that has been used for 10 years. I am not aware of any sort of situation where the state was left hanging by the federal government. You'd need to be more specific because that just doesn't fly. It's not stopped the vast majority of states from going ahead and implementing it. And, to account for that, you simply have a sunset where if the fed government eliminated funding for that population, it sunsets. Meanwhile, about $1 billion in funding for the state has been forgone each year for more than 10 years. That's a big deal.

I was part of it (in a very small way) when it happened. It was in the early 90s. The hue and cry when benefits were cut was tremendous. It was a sunset that the state didn't have the money to continue. You need to quit pretending that it can't happen, because it can and has. That has to be taken into account. You don't miss benefits you never had, but when they are cut there is a huge political price to pay. I am pretty well educated on the issue. I still don't know which would be best. That's why I said I wasn't up on it enough to know which would be best. It's not as cut and dried as EITHER side makes it.

 

[grimedawg1]

Why is the critical access hospital in Ruleville thriving? There’s been no expansion of Medicaid there. Medicaid and Medicare have terribly low rates of reimbursement therefore increasing low money losing reimbursement will not help much. Ruleville benefits from increased Medicare and I assume higher Medicaid rates for providers. The issue as you said is we decided to insure a lot more people but the real issue is the insurance sucks if you are a provider or hospital. The government needs to raise payments. By the way Medicare and Medicaid have scheduled a 10% payments cut to providers(healthcare heroes) in 2023.

You've chosen one hospital to say is doing well. It has had a loss in recent years too by the way.
Do you realize what a critical access hospital is as opposed to a hospital paid on the prospective payment system? Critical access hospitals are paid at cost for their medicare patients. They essentially cannot lose money on medicare patients.
Getting paid something, even if it is below cost, is better than getting paid nothing. Uninsured still show up at the hospital that have to be seen according to EMTALA. And, that funding, while on an incremental basis might not cover individual claims, it does increase total revenue that can help with fixed costs.
What's your source for 10% payment cuts in 2023?

 

[FrontRangeDawg]

I'm not up enough to know which would be better. I do know that Mississippi has been burned before by the Federal Government on this. They expanded it, or one of its programs, and then a few years later ended funding for it and the state had to pay more and cut benefits. It was a nightmare for the state. I think that has as much to do with Mississippi's stance as anything.

The federal government is not going to leave the state "hanging" on the program where 42 states have already opted in to avoid problems just like lack of access in rural areas. Most of the country is pretty rural still. This is not some scheme beyond the already ridiculous healthcare reimbursement system we already are stuck with.

 

[grimedawg1]

I was part of it (in a very small way) when it happened. It was in the early 90s. The hue and cry when benefits were cut was tremendous. It was a sunset that the state didn't have the money to continue. You need to quit pretending that it can't happen, because it can and has. That has to be taken into account. You don't miss benefits you never had, but when they are cut there is a huge political price to pay. I am pretty well educated on the issue. I still don't know which would be best. That's why I said I wasn't up on it enough to know which would be best. It's not as cut and dried as EITHER side makes it.

In the early 90s? Are you talking about moving from a cost based reimbursement system to a propsective payment system? That was not elimination of funding. That was changing the payment method. And, it was a medicare issue, not a medicaid issue. This was not at all a state funding issue. I am truly interested in what you are talking about. Can you provide some info on this? The politicians in this state would cite any sort of example they could find over and over if there were something tangible they could pin to their "funding might go away" argument.

 

[MSUGUY]

You've chosen one hospital to say is doing well. It has had a loss in recent years too by the way.
Do you realize what a critical access hospital is as opposed to a hospital paid on the prospective payment system? Critical access hospitals are paid at cost for their medicare patients. They essentially cannot lose money on medicare patients.
Getting paid something, even if it is below cost, is better than getting paid nothing. Uninsured still show up at the hospital that have to be seen according to EMTALA. And, that funding, while on an incremental basis might not cover individual claims, it does increase total revenue that can help with fixed costs.
What's your source for 10% payment cuts in 2023?

My friend that’s my point exactly : that Ruleville hospital and providers are paid at a higher rate therefore flush with cash! Underinsured is the real issue of you will.
You can google the rate cut, it’s coming unless congress acts but with republicans in charge doubt it will go away, it’s a 5% average across all providers but most doctors get 10% cuts.

 

[UpTheMiddlex3Punt]

I'm not up enough to know which would be better. I do know that Mississippi has been burned before by the Federal Government on this. They expanded it, or one of its programs, and then a few years later ended funding for it and the state had to pay more and cut benefits. It was a nightmare for the state. I think that has as much to do with Mississippi's stance as anything.

Are you talking about the Children's Health Insurance Program? I know it was originally funded with tobacco taxes and the proceeds from those taxes have gone down over the years.

 

[MSUGUY]

Are you talking about the Children's Health Insurance Program? I know it was originally funded with tobacco taxes and the proceeds from those taxes have gone down over the years.

Yep!

 

[grimedawg1]

My friend that’s my point exactly : that Ruleville hospital and providers are paid at a higher rate therefore flush with cash! Underinsured is the real issue of you will.
You can google the rate cut, it’s coming unless congress acts but with republicans in charge doubt it will go away

Ruleville hospital and "providers"....
Only critical access hospitals are paid in this manner. And, none are "flush" with cash.
Payments cuts were put in law with the anticipation that unreimbursed costs for uninsured would go down with expansion of medicaid. And, there is not anything near a 10% rate cut for 2023. Through republican and democratic control, these scheduled cuts have not taken effect. You can also google this.
And, the reduction would be in medicare, not medicaid. The feds would have to change the match rate to the state to reduce it's funding. There is no such proposal out there that affects medicaid.