Shrinking rural communities, Oklahoma's decision not to expand Medicaid as part of the Affordable Care Act, and cuts to Medicaid reimbursement rates have created a financial crisis for many of the state's smaller hospitals, The Oklahoman (http://bit.ly/2n6hePe ) reported.
"It's death by a thousand cuts that are not that big, but you put them all together and they are significant," said Andy Fosmire, vice president for Rural Health at Oklahoma Hospital Association. "Populations are declining in rural areas and folks in rural communities tend to be older, poorer and sicker than their urban counterparts."
Medicaid reimburses Oklahoma hospitals about 99 percent of costs, which causes Oklahoma hospitals to lose money on patients using Medicaid.
"If rates continue to decrease at the rate they have in the past 4 or 5 years, hospitals and other health care providers are going to have to start looking at all the services they provide to see if they are sustainable," said Brent Smith, CEO of Lawton-based Comanche County Hospital Authority.
The Oklahoma Health Care Authority oversees Oklahoma's Medicaid program. Since 2010, the authority has seen more than $446,000,000 in total Medicaid funding cuts.
"It's hurting all of our providers. We are just trying to protect Medicaid providers as much as we can," said Jo Kilgore, spokeswoman for the Oklahoma Health Care Authority. "We are just trying to make sure we pay all of our providers an adequate rate so they can continue to participate in the program."
As Oklahoma looks to fill a nearly $900 million budget hole, more cuts to Oklahoma Medicaid payments could be an option for providers in the next fiscal year.
Gov. Mary Fallin has proposed an 11.2 percent funding increase for the Oklahoma Health Care Authority, targeted for Medicaid-related programs for the state's 2018 budget.
Since 2011, nine rural hospitals in the state have filed for bankruptcy and shutdown under financial strain.
Information from: The Oklahoman, http://www.newsok.com
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