MERCER COUNTY Medicare ups payments to hospitals

The change will result in millions of dollars in new revenue.
By HAROLD GWIN
VINDICATOR SHARON BUREAU
SHARON, Pa. -- It's taken four years, but Mercer County hospitals are finally getting what they believe to be their fair share of Medicare reimbursements.
U.S. Rep. Phil English of Erie, R-3rd, announced Tuesday that the federal Center for Medical Services has come up with an increase for the county based on 2000 census data.
As of this month, Medicare payments to Sharon Regional Health System, United Community Hospital in Grove City and UPMC Horizon in Farrell and Greenville will be on a par with neighboring hospitals in other counties and across the state line in Ohio, English said during a stop at Sharon Regional.
The difference will mean millions of dollars in new revenue.
For nearly 20 years, Medicare payment rates for Mercer County hospitals have been significantly lower than rates paid to hospitals in Youngstown and Warren, as well as Lawrence and Crawford counties, said Wayne Johnston, president and CEO of Sharon Regional.
The discrepancy was based on Medicare regulations that set rates at one level for hospitals in the Mercer County Metropolitan Statistical Area and at a higher level for hospitals in the Youngstown/Warren MSA and in Lawrence and Crawford counties, he said.
Change in census
However, as a result of the 2000 census, the Mercer County MSA was merged into the Youngstown/Warren MSA, entitling Mercer County hospitals to the higher reimbursement rate, Johnston said.
He estimated the change will mean an additional $3 million a year in revenue for Sharon Regional, which runs an annual budget of about $130 million.
A spokesman for United Community estimated a $600,000 annual revenue increase in its $35.4 million budget.
UPMC couldn't offer an estimate on how much additional revenue is anticipated.
English said that, although the county was automatically entitled to the higher reimbursements, there was no requirement that the Center for Medical Services, an arm of the Department of Health and Human Services, adjust the amounts within any specific amount of time.
It's taken nearly four years of negotiations with CMS to get the new rates, English said, adding that a lack of money was apparently the reason for the delay.
Other areas across the country are having the same problem and some are still waiting for their rate increases, he said.
Lawmakers' efforts
Johnston praised English for his support and efforts to get the figures raised for Mercer County and also noted that state Sen. Bob Robbins of Greenville, R-50th, was very supportive and even traveled with local hospital representatives to Washington, D.C., to lobby for the change.
Johnston said the payment discrepancy resulted in Sharon Regional's having more long-term debt than it might have otherwise needed to buy advanced medical technology and equipment and to maintain modern facilities.
"Sharon Regional faces the same high costs for medicines, equipment and medical malpractice insurance as any other hospital. It is only fair that the payments be raised to reflect those realities," English said.
At 1,700 employees, Sharon Regional is Mercer County's largest single employer.
gwin@vindy.com