You fall, get into an accident or find that you need surgery and require care at a nearby hospital.
You don’t have health insurance, and don’t qualify for coverage under federal Medicaid or Medicare, but state programs such as charity care are in place to make sure you get treatment.
New Jersey hospitals use charity care money to treat low-income and underinsured people, but state funding for the program will again decrease for 2017.
State officials cited Medicaid expansion as the reason for less charity funding, but South Jersey hospitals said the expansion was not enough for most hospitals to care for the number of people they need to treat.
“You’ve got the homeless, undocumented residents, people who live under the radar. You’re talking some substantial numbers,” said Richard Pitman, executive director of Fair Share Hospitals Collaborative. “That’s where charity care will bottom out.”
Charity care reimbursement helps hospitals cover costs for underinsured and uninsured patients who need emergency services, pharmaceutical treatment, surgery, procedures and other in-patient care. Funding for each hospital is determined by a pre-set formula.
State legislators approved a 2017 fiscal budget that includes a reduction in charity care funding, which will be $200 million less than what was given to hospitals last year — the most significant cut to date.
Gov. Chris Christie and state officials said the Medicaid expansion in 2014 allowed nearly a half million previously disqualified residents to get health insurance under the federal program. Charity care claims have since decreased.
While local hospital officials said they have pushed to enroll patients in Medicaid, they are not enrolling enough people to make up for the money lost in charity care funding. Patient demand is still exceeding the hospitals’ costs, they said.
“The numbers are small for us and we’ve been taking a hit year after year,” said Robert Wood, director of finance at Shore Medical Center. “We’ve had some financial challenges trying to operate on those financial constraints, but we keep treating people because it’s the right thing to do.”
Shore Medical, in Somers Point, is one of several hospitals in South Jersey that has seen drastic reductions in its charity care funding. The hospital’s charity care funding decreased 84 percent from 2015 to this year, according to records.
Cape Regional Medical Center in Cape May Court House and Southern Ocean Medical Center in Stafford Township also have seen major cuts in charity care funding since 2015 and will continue to see more next year.
Thomas Piratzky, vice president of marketing and public relations and executive director of the Cape Regional Medical Foundation, said despite the Medicaid expansion, charity care funding is not enough to fully cover charity care costs.
The hospital will continue to “absorb the costs associated with that treatment,” he said.
A small number of hospitals in the state, called safety net hospitals, have maintained large amounts of charity care funding. Safety net hospitals were designated centers that would continue to serve a disproportionate number of uninsured and underinsured residents, despite Medicaid expansion.
AtlantiCare Regional Medical Center’s Mainland and City campuses and Inspira Medical Center in Vineland have not experienced the same cuts as other local area hospitals, but will see bigger decreases in 2017 than in previous years.
Although AtlantiCare received significantly more than others in previous years, charity care reimbursement has never fully covered the costs of health care for people who can’t afford it, said Walter Greiner, AtlantiCare senior vice president and chief financial officer.
“There is an undeniable need for sufficient charity care funding, which includes new funding,” he said. “We are committed to providing our community with care, regardless of ability to pay. We do so in an environment of increasing health care needs, especially acute and chronic care.”