Hospitals reluctant to pay for specialist

By PHIL GALEWITZ
http://www.palmbeachpost.com

BOYNTON BEACH — Palm Beach County’s hospitals are balking at paying a collective $1.1 million a year to ensure that residents seeking help at an emergency room have 24-hour access to a neurosurgeon.

Hospital officials say they should not have to bear most of the burden of providing the emergency coverage. Instead, funding also should come from sources such as county taxpayers, urgent care centers and nursing homes.

“If the community wants it, they should pay for it,” Robert Hill, CEO of Bethesda Memorial Hospital in Boynton Beach, said Wednesday. “The price of full coverage should not be put on the backs of hospitals.”

Hill was one of eight hospital CEOs meeting Wednesday night with leaders of the Health Care District of Palm Beach County.

Hospitals have struggled for five years to get specialists such as neurosurgeons, hand surgeons and gastroenterologists to handle emergencies. Some Palm Beach County emergency patients have had to be transferred to hospitals as far away as Gainesville and Miami because of the lack of local specialists.

The taxpayer-funded district last month put forward a financial plan to ensure emergency neurosurgery coverage countywide. For a total of $1.1 million, the county could guarantee that neurosurgeons would be on call in a local hospital for emergencies. The district’s financial formula was based on its estimate of a $2,250 daily rate to pay a neurosurgeon to be on call for 24 hours, plus $822 a day for the doctor’s medical malpractice insurance.

One hospital would serve as the primary “safety net” for neurosurgery emergencies. Other hospitals would pay to support neurosurgery based on their needs and emergency-room volume.

The district would kick in $145,000 a year toward the $1.1 million tab. Hospitals needing the coverage would pay between $100,000 to $300,000.

Health Care District CEO Dwight Chenette said some hospitals would save money with the plan because it would lower the amount they pay neurosurgeons to be on call.

None of the hospital CEOs endorsed the funding plan on Wednesday. JFK Medical Center CEO Gina Melby, for instance, said the Health Care District should pay a higher proportion.

They did agree to give the district more data to study the problem

Hospital and health district officials and the Palm each County Medical Society have been working on the issue since 2004.

Though most county hospitals are dealing with declining admissions and rising amounts of bad debt from an increase in uninsured patients, funding for other, unrelated projects has been available.

Bethesda, JFK Medical Center in Atlantis, Wellington Regional and Boca Raton Community Hospital have spent more than $150 million in just the past year to expand services.

Still, hospital officials say since they are reluctant to pay for a neurosurgery safety-net system that could attract residents of neighboring counties.

“Hospitals would feel more comfortable if some of the revenue was generated from other sources – urgent care centers, traffic fines, tolls, nursing homes,” said Wellington Regional CEO Kevin DiLallo. “There should be three legs on this funding stool, not two.”

St. Mary’s Medical Center CEO Davide Carbone said that although he’d like to see other sources of funding for the ER plan, he doubts taxing urgent care centers is a realistic alternative.

But DiLallo said other sources of funding are still needed. “Hospitals are already doing their fair share,” he said.

see original