Health care reimbursement rates

The following editorial appeared in The Inter-Mountain, Elkins, on Mon., Aug. 24:

West Virginia legislators can do nothing about some of the health care concerns state Senate President Bill Cole heard last week in Wheeling. That makes it especially important for lawmakers to act where they can make a difference.

Cole, R-Mercer, is a candidate for governor. He has been traveling throughout the state during the past few months, learning more about its different regions and about specific concerns and hopes of those who live there.

One of his stops Tuesday was Ohio Valley Medical Center, where several concerns were explained to him.

Rates at which Mountain State hospitals are reimbursed for treating Medicare patients are a sore spot, noted Michael Caruso, president and chief executive officer of Ohio Valley Health Services and Education Corp., OVMC’s parent company. He explained Medicare’s wage index for states sets reimbursement rates substantially lower for West Virginia health care providers than for those in most other states.

“Ours is the lowest paid, other than Puerto Rico,” Caruso said.

Medicare is beyond state officials’ control, of course. But Cole, Gov. Earl Ray Tomblin and others can enlist West Virginia’s congressional delegation in an attempt to address the issue.

Cole was able to offer some encouragement on another financial gripe, the cost of workers’ compensation insurance in West Virginia. Rates should be coming down noticeably once old workers’ compensation liabilities are paid off, he noted.

But on one issue, the ball is squarely in legislators’ court.

Caruso stressed to Cole that the state’s certificate of need and rate review processes need to be modernized. Many health care administrators throughout the state have the same concern. They have complained the systems stifle innovation and in some cases deny West Virginians access to important types of advanced health care.

Cole and his fellow lawmakers have an enormous amount of work on their plates. Issues such as tax and regulatory reform will take much of their time and energy. But quality, affordable health care tops the list for many West Virginians – and concerns such as those Cole heard need attention.


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