Carolinas HealthCare System could lose $500M over next 10 years

Reduced Medicare reimbursements and failure to expand Medicaid in both North and South Carolina could cost Carolinas HealthCare System $500 million over the next 10 years, according to

The 40-hospital system anticipated lawmakers would expand Medicaid, and agreed to reductions before the implementation of the Affordable Care Act, leaving their patients with less access to services, Chief Operating Officer Joseph Piemont said in the article.

Carolina HealthCare spent more than $870 million on the cost of uninsured, Medicare and Medicaid patients, and the system is not fully reimbursed for these costs.

"It's a serious reduction in revenue, and we're having to plan around that," Piemont told the news channel, although he doesn't think patients will have to pay more to compensate for the shortfall. In states that didn't expand Medicaid, some hospitals must make tough choices about cutting back cancer treatment, infant care and emergency programs to combat the budget issues.

To help reduce costs at the main hospitals, patients are going to community clinics instead--clinics that handle mostly uninsured patients.For example, clinics provide treatment for more than 80 percent of uninsured patients in Mecklenburg County in West Charlotte, N.C. Patients that choose the community clinic option avoid running up hospital costs while still having access to primary care physicians, checkups and discounted prescriptions, according to the article.

Lower reimbursements are causing problems for hospitals across the country. Franciscan Alliance, which serves patients in Indiana, Michigan and Illinois, said lower reimbursements contributed to the layoff of 275 employees in October, while IU Health in Indiana cut 900 jobs across the state, in addition to closing its Arnett urgent care center, FierceHealthcare previously reported. Alabama hospitals are also lowering wages and other expenses to offset the shortfalls caused by weak reimbursements, but lowering wage costs means a lower wage index, ultimately reducing reimbursements even further.

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