BAR HARBOR — Governor Paul LePage’s proposed biennial budget being debated in Augusta contains substantial cuts in hospital payments in addition to the high-profile tax changes, Mount Desert Island Hospital officials said last week. “There’s a lot of other policy debate here that has nothing to do with tax policy,” hospital CEO Art Blank said.
The hospital’s advocacy department hosted a breakfast meeting at the Atlantic Oceanside Feb. 5, where Blank outlined changes in the healthcare environment, potential impacts of the proposed state budget and how federal healthcare debates may impact MDI.
He emphasized cuts in hospital payments under the Critical Access Hospital (CAH) program and other reimbursement changes under MaineCare, the state’s Medicaid program, that have been missing from the public debate so far. “The budget proposal is complicated, and there are pieces no one’s talking about,” he said. There’s always a risk that these savings get hard-wired into the conversation” during budget negotiations, and “when they do come up, there’s not a lot of leverage left.”
The state Department of Health and Human Services, he said, was instructed to increase funding in this budget for two priorities: housing for developmentally disabled adults and Medicaid health homes. Cuts are scattered throughout the budget to offset that increase.
Those cuts may disproportionately impact rural health providers. Under the CAH program, overall reimbursements would be cut from 109 percent of costs to 101 percent of cost. The estimated impact on MDI Hospital is $290,000 per year.
Other payment cuts are planned to behavioral health programs, physician visits and public health funding. The budget would eliminate hospital-specific reimbursement for outpatient behavioral health services and reduce reimbursement for medication management services. MDI has one of only three such hospital-based behavioral health centers in the state.
Healthy Acadia executive director Elsie Flemings was on hand to discuss impacts of proposed cuts to public health programs, including the Healthy Maine Partnerships that created Healthy Acadia. Programs include anti-smoking campaigns and others promoting workplace wellness, healthy diet and physical activity. Many state public health jobs are currently vacant, Blank said, including public health nurse positions and state epidemiologist.