By: Ashmar Mandou

Guy Medaglia, president and CEO of Saint Anthony Hospital, has some serious questions for Governor Pat Quinn. “Are you really making the right decision? Is there not a better way to do this?,” asked Medaglia. The questions were in reference to Gov. Quinn’s proposed Medicaid cuts late last month, which left many community hospitals paralyzed in fear of losing much needed services for uninsured and underinsured residents. “There has to be a better solution than to just slash and burn. That’s how I’m looking at this. It’s just slash and burn.”

Nestled in the heart of the Lawndale community, Saint Anthony Hospital treats nearly 30,000 Medicaid patients every year. In fact, it’s one out of every two patients that walks through the hospital’s doors. According to Saint Anthony Hospital, more than half of its current patients are of Hispanic descent and another third are African-American, the proposed cuts will have a devastatingly large impact on those two groups, said Medaglia. Caring for one of the neediest communities is no easy feat, but somehow Saint Anthony Hospital manages to offer free screenings each year, parenting education, and mental health services, to name a few. “When I became a part of the Saint Anthony team five years, this hospital was ready to close its doors,” said Medaglia. “The hospital was in debt. Not many services were provided, but instead of cutting the staff, cutting services, I decided to increase volume. I hired more people, bought more medical equipment, had equipment donated to us. I did whatever I had to do to keep this hospital running without cutting. And that goes to show you that growth benefits more people.”

Recently, Medaglia phoned our office to discuss further actions Saint Anthony Hospital intends to take and recommendations Gov. Quinn should take into consideration.

Empathy
We understand that the governor has a very difficult task facing him. But what my concern was is that it was a group of people that never saw faces. To me, it was just about the numbers. There is a difference in my mind, this is just me speaking, there is a difference between for-profit organizations that have an obligation to their shareholders and non-for-profit organizations that have an obligation to whoever they’re serving.
In this particular case, we have a government program called Medicare and Medicaid and there are people that rely on that program. And to just say, ‘we have a budget problem, we have to make cuts, this is a big number, let’s cut it’ to me, is a little scary. Because of the fact that it is easy for someone that only sees numbers and doesn’t see faces. But when you live in the community and you see the faces it is very concerning.

Recommendations
Collect federal dollars on all current HFS plans
There are at least ten unapproved state plan amendments at HFS representing over $100M in unclaimed Federal monies. Recurring revenues would be $30-$40M.

Ensure all Medicaid recipients are eligible
The state is not being aggressive in determining if individuals still qualify for Medicaid. Of 2.7 million enrollees, there are 100,000 – 300,000 individuals who, because of income, no longer qualify but who have not been properly removed from the program. The average Medicaid per month spending is $200. Removing 100,000 – 300,000 would likely save $240 – $720 million.

Identify Medicaid patients with alternative coverage
Alternative coverage exists for many Medicaid recipients. By identifying third-party liabilities and credit balance recoveries at hospitals, past and future billings to insurers would provide significant savings. Statistical comparisons were made to Texas, Iowa and Florida. Estimates are conservative at 1/3 of costs recovered in other states.

Message to Governor
I would like to tell him this, I am very sympathetic and I really appreciate the challenge you have in front of you, but I would suggest pulling more minds together and coming up with a better solution to try to find a way to build revenue and not cut. And I don’t mean ‘build revenue’ by way of taxes, I mean through the way of federal governments, through the way of brining in more employers. We built this hospital by increasing the volume; we didn’t fix it by cutting. I haven’t let go of one person in the five years that I’ve been here.