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UPDATE: Future still not clear for MRH as Obamacare kicks in

Even as the nation’s universal healthcare system kicks off, it is still not clear what affect it will have on hospitals, doctors, employers and workers, Mary Rutan Hospital’s President and CEO Mandy Goble told the Bellefontaine Rotary Club on Monday.

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It appears Obamacare, as it is informally known, will cut into small-hospital revenues, carry penalties and put more regulatory reporting burden on providers.

“They say we’re one of the two most regulated industries in the nation,” Mrs. Goble said of the medical profession. “Second behind nuclear energy.”

She estimates 20 percent of the hospital’s 730 employees work on billing, insurance and regulatory compliance issues.

CLICK HERE to view a graphic shown during Mrs. Goble's presentation, which illustrates the complexity of Obamacare.

While today is considered the official start of the 10-year phase-in of Obamacare, hospitals have been paying into the system since 2010, she said.

Most of the payments have come in the form of cuts to Medicaid and Medicare reimbursements. Also major managed healthcare firms such as Humana have also cut payments.

The percentages of the cuts are small, but add up to big money for hospitals, she said.

Obamacare also seems to favor larger hospital chains. Many are merging and she expects the trend will continue.

MRH remains a stand-alone hospital and has aligned itself with The Ohio State University Wexner Medical Center to provide specialized and critical care.

The relationship also helped cut nearly $1.1 million in supply costs last year, she said.

Ms. Goble said MRH is not big enough nor deemed a “critical” facility to take advantage of reimbursement opportunities built into Obamacare for the large chains and small rural hospitals such as those in Urbana and Kenton.

The hospital continues to face challenges of attracting new physicians to the area and competing with big city physician-managed facilities for same-day surgeries.

Fortunately, MRH has a strong financial base to weather the uncertain days ahead, Mrs. Goble said.

In 2012, MRH saw revenues of more than $83 million and expenses of more than $80.3 million. It provided more than $4.7 million in charity care.

Current cash reserves are enough to cover 250 days of operations, she said, three times the national average of 80 days.

MRH’s debt is also better than average. Its debt-to-revenue ratio is 17.9 percent while the national average is 27 percent and the average for Ohio is 46 percent, Mrs. Goble said.

As the program develops, employers and employees will want to keep an eye on the tax for “Cadillac” programs, she said.

The law sets a $10,200 per year limit and anything above that benefit will be taxable, she said. There is no adjustments for inflation and no clear definition of what will be measured.

It could be the annual value of the employer’s share or the employee’s share or the amount of care used in a year, she said.

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