Finding Money for the Crippled MED

Memphis, Tn - Administrators at the Regional Medical Center in Memphis are telling state lawmakers in Nashville to increase its' annual subsidy (approximately $32 million) to the level one trauma center, or they may have to close the doors within the next few months.

"Simply stated, we need thirty two million dollars a year in additional operational funding," said Gene Holcomb, Med Board Chairman.

"I'm not real interested in continuing on with the process of once a year there’s a crisis and we need x millions of dollars or we can't make payroll next month," said Tennessee Governor Phil Bredesen.

Bredesen has expressed a reluctance to continue subsidizing the Med, unless hospital administrators present a comprehensive operational plan, going forward. Additionally, the Governor is proposing $200 million in Tenncare cuts that would reduce annual Med revenues, from federal reimbursements, by approximately $52 million.

Holcomb said those moves would cripple the Med.

"This is it," Holcomb said. "Unless the city and or county wanted to come up with the $52 million. Because, again, we needed the $32 million plus the $52 million dollars."

The Med's financial condition is always critical because of all the un-compensated care it provides. Fiscal Year 2009 estimates show the Med providing more than $160 million in charity care.

To help fill that hole, Shelby County and Tennessee have historically provided subsidies, $27 million and $32 million, respectively.

Shelby County Commissioner Mike Ritz recently filed a complaint against the State of Tennessee, with the Department of Health and Human Services.

"We've been shorted something like fifty or sixty million dollars a year," Ritz said. "The State of Tennessee collects $90 million a year on our uncompensated care, charity care, and they only send us $30 million."

That's not enough to cover the poor and un-insured in Tennessee, not to mention the non paying patients from Mississippi and Arkansas, who accounted for $34 million of the $160 million in the Med's un-compensated care in 2009. Because of that, some in the medical community are saying it might be time to shut the Med down.

"I think the political leaders here, both mayors and the leadership at the Med are going to have to step up and say we don't have the money to provide care to the other states," said Ed Avery, Administrator, Consolidated Medical Practices of Memphis. "The money's just not there."

"We're under increasing tax pressure and there just very well may not be the money available to support the med. We have to have a level one trauma center, the question is where can we provide a level one trauma center service at a place we can afford. There are ten emergency rooms (in the region). There are ambulances and operating rooms. The rooms and the buildings are there, it's a matter of transferring the equipment and the staff to the facilities, if that's the most cost effective way of doing this."

While the thought of closing the Med has been on the minds of local politicians, like a nuclear option, it's something they don't want to have happen.

"We're going to have to pick up some additional funds from Nashville and I think we will," said Shelby County Mayor Joe Ford.

"It's a radical step, it's a controversial step. It may or may not be the right answer, but you've got to ask the question," said Avery.

"If the Governor doesn't return the Tenncare money to us and help us with these additional needs, I don't think there's going to be enough votes to raise the money to keep the Med open," said Ritz

Med administrators say if Tennessee contributes $35 million a year, not only could they keep the hospital open and operating on a break even basis, but they could also build a new $350 million facility in five years.

On March 1, the Med named Dr. Reginald Coopwood as its' new chief executive officer.