| As Nebraska and Iowa, like many states, reduce Medicaid payments to hospitals and freeze reimbursement rates for doctors, it takes a toll on the cost and stability of healthcare. |
• More than 50% of all hospital stays in Nebraska and Iowa are paid for by Medicare and Medicaid, making hospitals highly vulnerable to major changes in public policies.
• Alegent Health hospitals are reimbursed approximately 28 cents on the dollar (charges) for Medicare. Medicaid reimbursement is 27 cents on the dollar.
| Changes in Medicaid and Medicare eligibility and reimbursement rates threaten the availability of care for Nebraska's and Iowa's most vulnerable citizens: the young, the poor, the elderly, the disabled. |
• About 16,000 children and 12,000 adults are being removed from Medicaid due to cutbacks.
• Nebraska has reduced Medicaid coverage for people who leave welfare and obtain jobs. Such coverage, previously available for two years, is now provided for just one year. Source: "Most States Cutting Back on Medicaid, Survey Finds," New York Times, January 14, 2003.
• Iowa has increased premiums for working disabled people's Medicaid coverage.
Source: Center on Budget and Policy Priorities, LOSING OUT: States Are Cutting 1.2 to 1.6 Million Low-Income People from Medicaid, SCHIP and Other State Health Insurance Programs by Leighton Ku and Sashi Nimalendran, December 22, 2003.
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| The Health Insurance Portability and Accountability Act of 1996, known as HIPAA, has a broad impact on all health providers, insurers and consumers. |
• HIPAA established standards to protect the privacy of each person's individually identifiable health information. Hospitals must comply with these privacy standards — and the rules regarding the way hospitals may use or disclose "protected health information."
• Many healthcare providers have found that these regulations go beyond what is necessary to protect privacy, producing new layers of administrative "red tape" and enormous costs in the establishment of new departments, IT infrastructures and new administrative processes required for organizations to reach compliance.
• A study commissioned by the American Hospital Association (AHA) in 2000 estimated that the average cost of HIPAA compliance per hospital ranged from about $670,000 to $3.7 million — and that HIPAA training would cost about $16 per employee.
• Alegent Health spent in excess of $1.85 million to operationalize HIPAA regulations and, using the AHA estimate of $16 per employee for training costs, invests more than $120,000 in HIPAA training a year.
| Other unfunded mandates also strain resources of healthcare organizations. |
• Alegent Health spends $1.5 million a year to provide required interpreters. |
