Fulks: State facing tough healthcare choices

Published 4:49 pm Sunday, January 1, 2017



In emergency medicine, the “golden hour” immediately after a traumatic event like a car accident or a heart attack is the time in which the patient’s chance of surviving can be most improved by access to skilled medical care. Today, Georgia’s healthcare system faces a “golden hour” in which legislative action is required to ensure the long-term survival of the local hospitals that protect our families, our communities, and provide high-quality healthcare and well-paying jobs.

Hospitals are the lifeblood of the communities we serve. They are where sickness is treated, lives are saved and children are born. They foster wellness, provide quality jobs and give us the assurance that if an accident happens, help is nearby and available 24 hours a day. Unfortunately, too many communities across our state have either lost or are at risk of losing this liefsaving resource. Five Georgia hospitals have closed since 2010 and at least 10 are at risk of shutting their doors.

Simply put, our statewide hospital network requires immediate stabilization to ensure that no more communities lose access to healthcare.

Whether rural or urban, 50 beds or 500, Georgia’s hospitals face an uncertain future. Changes brought about by the Affordable Care Act, lower reimbursement rates for services, and an expanding population of uninsured patients are just a few of the very real challenges providers face every day.

While the incoming Trump administration and members of Congress have pledged relief, those changes will take time to identify, implement and, most importantly, to understand the impact they will have on insurance, Medicaid and the cost of care.

This is the backdrop against which the Georgia General Assembly will be making decisions about health care as they reconvene on Jan. 9.

The first measure to stabilize our hospitals is renewal of the Medicaid provider fee, which helps fill in a financial hole left by the federal system. Some call it a “bed tax,” though no tax is levied on patients or on hospital beds. Without legislative renewal, the provider fee will expire on June 30, 2017, and Georgia will lose hundreds of millions of dollars of our own federal tax dollars.

Georgia’s legislative leaders have made it clear that addressing the renewal of the Medicaid provider fee will be a top priority for the coming session and we hope they succeed.

Another area in which Georgia’s community hospitals need stability rather than increased risk is maintaining the certificate of need program that protects local hospitals.

Georgia’s certificate of need law was put into place nearly 40 years ago to ensure that all citizens would have access to care – no matter where they live, what their income level or how serious their condition. These laws require that any new medical facility or hospital expansion meet a true unfilled need.

Why is this important? Because hospitals, especially not-for-profit facilities, rely upon a delicate balance of services, patient mix and reimbursement levels to maintain their financial viability. Requiring proposed expansions or new facilities to go through the certificate of need process helps to safeguard that critical balance while expanding medical care where it is needed the most.

Proposed changes to the certificate of need law will be among many health care issues our legislators debate this coming year, but few will be more important given the potential impact on local communities throughout our state. In some cases, those decisions could mean the difference between a hospital staying open or closing; in others, difficult choices about what services to provide or eliminate. No one should ever lose a loved one or suffer more than necessary because they did not have timely access to quality care.

Georgia’s local community hospitals are in a golden hour of their own, in which their financial health must be stabilized after years of change at the federal level. Georgia is fortunate to have elected leaders who share our commitment to maintaining a health care system that all citizens can rely upon and we look forward to continuing to work with them to ensure continued access long into the future.

Jerry Fulks is President of WellStar West Georgia Medical Center in LaGrange, Georgia and serves as Chairman of the Board of Directors of the Georgia Alliance of Community Hospitals.