Current agreement outdated, parties in arguable default.
Is less or more support for University Hospital necessary?
The indefatigable and prolific reporter Laura Ungar covered last week’s board meeting of the Quality and Charity Care Trust (QCCT ) for the Courier-Journal. Apparently the meeting was largely informational with no formal action taken. It was reported to the QCCT board that the percentage of uninsured patients for the first three months of this year decreased to 13% from 23%. This is good news of course, but University Hospital, like all other hospitals and safety-net providers, remains appropriately concerned about the ultimate effects of the accountable Care Act on overall provider revenues. All of us have our fingers crossed. Time will tell.
The substantial decrease in state funding for the QCCT that emerged from the recent Kentucky legislative session from the current year’s $18 million to $6 and $4 million in the next two years was obviously a subject for discussion. Apparently Louisville Metro is also decreasing substantially its annual local government contribution from the current $7 million, but this the first I have heard of that additional reduction. [Anyone out there who can clarify things for us?]
Funding and implementation of current program obscure at best.
What caught my eye and stimulated this article was a statement that in addition to the specific yearly state legislative appropriation, that the University of Louisville augments the state total from its own “fixed general funds” in the amount of an additional $5 million. As hard as I have been trying to learn about the finances and administration of the QCCT, this latter source of funding was also news to me. I confirmed from a University spokesperson that this additional funding is linked to the controversial and mysterious “rent” that has been paid by University Hospital to the University. This “pass-through” of money from University Hospital to the University of Louisville, to the state, and back to the QCCT for clinical care is part of a long-standing intergovernmental transfer (IGT) mechanism used to pull down matching Medicaid money for the state’s use.
Note that previous declarations of the “rent” paid by the Hospital to the University spoke of $8,876,993. I am not confident that everyone is talking about the same thing! When talking about public money, it should’t be this confusing. Continue reading “Is the QCCT Agreement That Supports Indigent Care Still In Force?”