“ There is so much that goes on inside a hospital , and it always blows me away ,” says Kaufman . “ I ’ ve been in health care for more than 25 years . I ’ ve toured a lot of hospitals , from large , 1,000 + bed academic medical centers to small , 25-bed critical access hospitals . Someone made a comment to me one time that I must get bored of touring these hospitals , but that has never been true . Every time I visit a new hospital , I learn something new , and I see what they are doing to address the needs of their communities .”
These programs are made possible , in part , by hospital partnerships .
“ If you need care in an emergency situation , you know hospitals are there standing ready , but they are not alone ,” says Kaufman . “ Hospitals work closely with traditional partners such as primary care physicians , federally qualified health centers and rural health centers , but a lot of people don ’ t realize there are a lot of nontraditional partnerships as well . Health care doesn ’ t start and stop with physicians ’ offices . There are a lot of other things that impact health care , so you start to think about relationships with food shelters , job services , law enforcement and faith-based organizations .”
Most of West Virginia ’ s hospitals are fostering these relationships and serving their communities while operating at a loss . According to Kaufman , 67 % of the state ’ s hospitals operate in the red . Since 2013 , half of all hospitals in the Mountain State have been losing money on patient care services , and the coronavirus pandemic is only exacerbating existing problems .
Many of the financial burdens hospitals carry in West Virginia come down to the types of health coverage West Virginians have . More than 70 % of West Virginia hospital patients have coverage through Medicare , Medicaid or the West Virginia Public Employees Insurance Agency — government programs that all pay less than the actual cost of patient care .
“ I ’ m looking at this and wondering how we keep our doors open ,” says Kaufman . “ How do we continue to provide services to the community ? That is one of the biggest challenges I see in West Virginia .”
Most of these problems are not West Virginia specific . The state is being impacted by national trends as well , according to Kaufman .
“ We are not in isolation ,” he says . “ What happens on Capitol Hill and within the broader health care marketplace definitely impacts what ’ s going on in our state Capitol , the advocacy space and the health care delivery system .”
Despite these challenges , Kaufman recognizes West Virginia ’ s hospital leaders , clinicians and staff who are finding a way to make due with what they have while continuing to make a significant impact .
“ They recognize there is a limitation on what they can do when there is no money , but they are finding a way to make it work ,” he says .
West Virginia ’ s payor mix puts a strain on private insurance companies , which typically pay more toward health care costs than government programs .
“ For years , the business community has been shouldering that financial burden ,” says Kaufman . “ Now , it is making it hard for them to compete . I ’ m sure every business is saying one of their main challenges is how to pay for health care . For years , they were shouldering that additional cost because governmental payors were below cost . That is one of the challenges we ’ re dealing with now . How do you deal with that and make it fair and equitable while ensuring access to care ? Health care financing is complicated .”
Hospitals have access to a few other revenue streams that help them make their budgets work .
“ Hospitals are complex operations ,” says Kaufman . “ They are running facilities that offer supplemental income . Cafeteria income helps support as well as investment income . One of the biggest things people don ’ t think about is community support through philanthropic gifts , donations and capital campaigns .
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