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Budget and TennCare Top Legislative Priorities

The Tennessee Hospital Association's (THA) Legislative Day on the Hill is scheduled for February 17th, and the 2009 budget will top their agenda.

"It's all about the budget," said Craig Becker, president and CEO of THA.

The state's administration is currently looking at large budget cuts to TennCare, and THA believes such a reduction could drastically affect patient care.

"Cutting a billion dollars out of the TennCare budget really would have a dramatic impact on the hospitals in the state," explained Becker. "So we are certainly going to present the case that we will not be able to continue providing care the way we currently do if these cuts go through."

Additionally, THA plans to work with federal elected officials to lobby for inclusion in the economic stimulus package, which would provide much needed relief for both the state and hospitals.

While such tasks may seem daunting, THA approaches 2009 encouraged by the goals accomplished in 2008, despite last year's lack of funding.

"It [2008] was a difficult year. There was no money to be had, but we were still able to keep our hospitals whole," commented Becker. "We were also able to get some of the legislative initiative we were trying for, particularly some insurance reform as it related to the emergency room and weekend admissions. That was a big victory for us."

While the budget and TennCare are number one on THA's list of priorities, maintaining the Certificate of Need Program (CON) follows closely behind. "There is potential move of foot to do away with the Certificate of Need, and for hospitals, that would be disastrous," said Becker.

Loss of the CON concerns THA because hospitals could potentially lose many customers and consequently many dollars. The CON program currently regulates the market and assures that all healthcare projects develop fiscally responsibly, maintaining adequate and effective healthcare for all Tennesseans.

"As long as we have to take all comers regardless of ability to pay and others don't, then it is impossible for us to compete against them on a level playing field," explained Becker.

Also on the list of 2009 legislative priorities is insurance reform, specifically insurance repair issues. THA wants certain administrative issues simplified to make it easier for hospitals to get patients in and out, and to get paid for their care. Basically, THA desires that insurance/payor relationships be repaired through ease of process.

"We have seen too often insurance companies throw up as many roadblocks that they can to make sure that they don't have to pay us, and make us jump through all kinds of hoops in order for us to get paid," added Becker.

Tort reform, an issue not initially anticipated by THA to be prioritized, will also be addressed in 2009. According to Becker, "With Republicans taking over the House, it will probably come back front and center, and we will certainly be supportive of any action in that area."

As in the past, THA hopes to collaborate with other state hospital groups, including, but not limited to, Hospital Alliance of Tennessee, an association for not-for-profit community hospitals, and the Tennessee Public and Teaching Hospitals, Inc.

"We will certainly be working closely with them; they are key partners," commented Becker, "And with the proposed changes to the TennCare budget, we will be working with our physician friends as well. If they are impacted by it, so are we."

The economic predictions for 2009 seem to be a top concern among all healthcare facilities, practices, and organizations across the state, but rallying support and becoming proactive could potentially lighten the load.

"The budget is going to overshadow everything, and they ... healthcare professionals ... are going to have to make their elected officials both at the state and national levels aware of the impact cuts are going to have," suggested Becker. "They should make their case, explain . . . what a 7 1/2 (percent) decrease in their TennCare rates would do to them."

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