Medicare reimbursement one of year's success stories

It's still hard to believe, but one of the success stories of the 2003 session of the U.S. Senate and House of Representatives was approval of additional Medicare reimbursements for seven rural hospitals in Nebraska, including Community Hospital of McCook.

As a part of the Medicare reform bill, the increase in funding was passed by both houses of the U.S. Congress and signed into law last week by President George W. Bush.

It will take a while for the changes to take effect, but when fully implemented in the last half of 2005, the "Rural Community Hospital Demonstration Program" will mean up to $22 million in additional reimbursements from Medicare over a five-year period.

Wow! That's not only a whole lot of money, it's also the fair thing to do because the rural hospitals in Nebraska have had to cover Medicare costs by dipping into other resources for the past seven years.

In the case of Community Hospital, the hospital president and CEO, Gary Bieganski, estimates the shortfall of reimbursements to cost for providing Medicare services has amounted to between $3 million and $5 million over that period. And the situation was much the same at other, similar sized Nebraska hospitals, including those located in Alliance, Lexington, Holdrege, Broken Bow, Beatrice and Columbus.

Yes, there was a problem, but what could be done about it? Daring to dream the impossible dream, Community Hospital's Bieganski and Terrance Padden of Alliance and Cal Hiner of Lexington started asking, "Why not go to our representatives in Washington? The problem is a federal one, and they are our best hope for a solution."

So, with the help of Nebraska's other, mid-sized Nebraska hospitals, that's what the hospital administrators did. It was a long, difficult and frustrating journey, with many starts and stops along the way. But thanks to the help of U.S. Sen. Ben Nelson and U.S. Rep. Tom Osborne, and the encouragement of U.S. Sen. Chuck Hagel, the "Magnificent Seven" of Nebraska prevailed, securing the legislation needed to right an unfair Medicare fund distribution formula.

It's a huge deal, especially when you consider that 61 percent of the patients at Community Hospital last year were on Medicare, and their total time in the hospital accounted for 70 percent of the patient days.

Two more years of belt-tightening will be necessary for the Nebraska hospitals, but thanks to a magnificent, grass roots campaign, needed aid is on the way to help care for Medicare patients.