New tax credit is a ‘lifeline’ for Georgia’s rural hospitals

SYLVESTER — In here, a couple of senior citizens lift small hand weights. In there, cardio machines idle until the next users arrive. In the extra-wide hallway connecting them, a stairstep sits off to the side. The lone sign that this physical therapy department used to be an operating room is the thick red line of tile just in front of the double doors that no longer fly open for inbound stretchers.

Inside the erstwhile operating room at Phoebe Worth Medical Center. (Photo by Kyle Wingfield)

Inside the erstwhile operating room at Phoebe Worth Medical Center. (Photo by Kyle Wingfield)

“As we change, we make do, and we make things fit in different areas,” says Kim Gilman, chief executive of the Phoebe Worth Medical Center in this town of 6,200 halfway between Albany and Tifton. “Some more funds would make it more efficient.”

Funds have been hard to find at this rural hospital, like others across the state. Medicaid expansion, long off the table in Georgia, was set for serious consideration in 2017 — until Donald Trump’s election threw the future of Obamacare into doubt. States may get more flexibility for Medicaid funding, but no one is sure yet. For now, there is promise in the form of a new state tax credit for rural health providers billed as the first of its kind in the U.S.

“It truly is a lifeline,” Gilman says.

The credit is the brainchild of state Rep. Geoff Duncan, R-Cumming, who modeled it after Georgia’s existing tax-credit scholarship program. Donors to eligible rural hospitals can file for a credit on their state income taxes (individual or corporate). Legislators approved it late in the 2016 session, putting $50 million in the pot for next year, $60 million for 2018 and $70 million for 2019.

The credit is worth only 70 percent of the donation — the scholarship credit is dollar-for-dollar — so no one knows what to expect when it goes live Jan. 1. But officials at four rural hospitals I visited during a South Georgia swing this month expressed hope it will help them bridge a very precarious financial gap.

The economics of health care is broken, and nowhere is this more evident than in rural hospitals. Phoebe Worth reports providing more than $8.4 million in charity and indigent care last year, plus almost triple that amount in uncompensated Medicare and Medicaid services. The new private plans on the Obamacare exchanges have hardly helped: Most carry such high deductibles that neither patients nor hospitals get paid.

It’s a familiar story in rural Georgia. The new tax credit could provide a huge shot in the arm. If all the credits are claimed, almost $260 million in donations will flow to about four dozen hospitals.

Building upgrades and new equipment could be in the offing. So could new services that have high upfront costs but would be profitable once established, sustaining themselves and cross-subsidizing other, loss-making services. That could include telemedicine technology that allows patients to see specialists from cities such as Atlanta without traveling too far from home.

“It wouldn’t take much (upfront investment) and would still be cost-effective,” says Michael Hester, CEO of Liberty Regional Medical Center in Hinesville.

But even those kinds of investments are difficult for hospitals to make when they’re bleeding money on each patient. At Phoebe Worth, a new floor for the emergency room cost $50,000; the hospital needed two years to scrounge up the money. “Squeezing quarters out of pennies,” the hospital’s chief financial officer, Candace Guarnieri, calls it.

The state needs a broader overhaul of health care (hint, hint, aspiring governors). This new tax credit may be rural hospitals’ best bet for surviving until that happens.

Reader Comments 0

79 comments
ATLAquarius
ATLAquarius

"The economics of healthcare is broken"...we will see just how interested conservatives are in fixing it absent a mandate to buy into insurance...you can talk about telemedicine and other preventive and maintenance care all you want but trauma care and treating disease along the medicine require to maintain a quality of life will have a price tag...Obamacare absent a mandate or cost controls was not the answer but I'll yet to see anyone outside of right leaning think tanks adequately diagnose the issues let alone attempt to present real legislation to address it...put the mandate to good use and address an issue that can't be slogannered into a bumper sticker

Dimick
Dimick

One of Kyle's favorite guys is tapped for Health and Human Services Secretary. 

Tom "high risk death pool" Price. What's the maximum out of pocket deductible for you assured death care policies Mr. Price? Oh, I forgot, if I have to ask I can't afford the policy. I'll take a guess for fun Mr Price, is $10,000 dollars in the neighborhood and the benefits covered are limited to in the pine box  palliative care? 

Got to cut cost somewhere aye Tom. 

Yes indeed we need every penny we can get from Casino gambling, horse racing, beting on sports event or anything else we can invent to raise the revenue which are going to be needed to keep the doors open on the hospitals rural and urban.        

AndyManUSA#45
AndyManUSA#45

Now that the recount is dead, like castro, time to move on to the business at hand -


WASHINGTON — The Senate voted overwhelmingly Monday evening to confirm Eric H. Holder Jr. to be the new attorney general of the United States. The vote was 75 to 21, with all the votes against the nomination coming from Republicans.


But other Republicans said they would vote for Mr. Holder despite his acknowledged mistakes. Senator Jeff Sessions of Alabama, for example, said he was sure that Mr. Holder would be “a responsible legal officer and not a politician.”


http://www.nytimes.com/2009/02/03/us/politics/03holder.html?_r=0


KA


BOOM!

SGTGrit
SGTGrit

The tragedy of today that could have been much worse on the Ohio State campus if it were not for the quick reaction from a campus policeman. This latest incident underscores the validity for hard vetting of foreign nationals coming into this country who're currently given a free pass as refugees. Undoing the damage levied on this country by Barack Hussein Obama, over eight years must be reversed beginning January 20, 2017.

SGTGrit
SGTGrit

Tim Ryan, congressional Democrat from Ohio, says that Democrats are no longer a national party. He's absolutely correct. The hard left has pushed what was once a respected national party into a strategy of controlling the vote in huge population centers within the West coast states and the Northeastern states. This would mean if it worked that only a handful of states would control the outcome of national elections. Many of us have pointed out the negative impact such a strategy would have if the left were to be successful in a Republic such as ours with collective state representation. One third of all congressional Democrats come from only three states. Thank goodness for the foresight of our founding fathers.

Dimick
Dimick

To call this tax credit a "Lifeline" is over the top it is more like the "thinnest thread".


Tax credits offer hope for rural hospitals

Read this article and you'll see why I've been busting Kyle's chops all day.




 http://chronicle.augusta.com/opinion/2016-11-26/tax-credits-offer-hope-rural-hospitals

PS.  The only thing that will do the job and solve our healthcare problems along with the others we have in this healthcare starved state, Sen. Stone, is to allow casinos and other forms of gambling into this state to SOLELY fund healthcare. This is our only real hope, Sir. We need hundreds of millions of dollars or Billions of Dollars that casino revenues can provide on a year after year basis. 

 Please support casino gambling to fund healthcare not MARTA or HOPE

AndyManUSA#45
AndyManUSA#45

"According to Wanda Murren, spokeswoman for the Pennsylvania Department of State," the Philadelphia Inquirer reported Monday, "the deadline for a voter-initiated recount was Monday, Nov. 21." 


And without Pennsylvania, that's that.


These^^ are the amazingly stupid people that have been running our country for the last ten years and who the democrats wanted to give another 8 to. Amazingly stupid. The exact words Trump has been using the whole campaign. hillary blew the get out of jail free card, burnt down the bridge, for what? Swept away in the mindlessness. 


Now all we have left is an audit of the dead and illegal voters, a number that can be easily projected across the entire United States to show that Trump did indeed win the popular vote.


Thank you, Jill!

Dimick
Dimick

@IReportYouWhine  Or December the 13th according to Judge Andrew Neapolitan.

Go Trump and appoint someone other than Tom Price Secretary over HHS

AndyManUSA#45
AndyManUSA#45

@dimik @IReportYouWhine Not true. The deadline for a voter initiated recount was Nov. 21st. The only recourse left is a lawsuit that provides evidence of vote fraud and they've already publicly announced that they have no evidence.


It's dead, like castro.

Dimick
Dimick

@IReportYouWhine @dimik  The judge was speaking of a one particular state I believe. States do  have different law governing how recounts are to be conducted. 

It's worse than dead they don't have a body. :)

AndyManUSA#45
AndyManUSA#45

Absent the payment, there will not be” a recount, Wisconsin Commission Chairman Mark Thomsen said Monday.



“If nothing else, this will give us audit,” he said. “We are not counting illegal people. We are not counting dead people’s votes.”



http://www.foxnews.com/politics/2016/11/28/wisconsin-officials-agree-to-proceed-with-vote-recount-but-not-without-full-payment.html



I have another prediction; Trump wins WI by 13,000 votes instead of the 10,000 lead he has now. (green bay is ate up with liberals.)


Bank it.

AndyManUSA#45
AndyManUSA#45

Due to recent earth shattering news being announced, I must amend my previous prediction; Jill Stein, having fleeced the Nation of Stupidity of 7 million dollars, will not even make the payment for the WI recount. Nor will she offer soros a refund. She will hire some bodyguards and exercise her 2nd amendment rights.


Facts.

Dimick
Dimick

Push to approve Casino Gambling including other forms to collect the revenues that shall fund healthcare not MARTA and HOPE. 


Otherwise buy into Kyle's a little here a little there and somewhere somehow when all these little bits come together we've fixed healthcare. 



Dimick
Dimick

Furthermore that "aspiring day" is now.

Dimick
Dimick

Real fact is that the revenues this state could collect from casino gambling is a way to fund the missing parts of healthcare here in Georgia for hospital where this donor bill will not.   

AndyManUSA#45
AndyManUSA#45

For those of you keeping track, my new blog name is AndyManUSA#45, I just changed it again, fat lot of good that did.



Eye wonder
Eye wonder

@IReportYouWhine

You know the saying about taking New Yorkers out of New York but not taking New York out of New Yorkers?  

The essential 'you' has now been defined by your reporting and whining. A rose by any other name...

AndyManUSA#45
AndyManUSA#45

@Eye wonder @IReportYouWhine Yes, eyeball, that's why Florida has been turning pinkish lately, all the new yorkers moving there to avoid paying new york taxes. But then they vote for democrats again. Not very smart people, huh?


You know what the #45 stands for, dontcha?

Eye wonder
Eye wonder

@IReportYouWhine @Eye wonder

"T-roll"

I like it! 

I can picture you sitting there, Mr. T-like, with your Chinese-made, Trump-branded gold swag, and a large red hat that says "IRYW T-ROLL."

JeffreyEav
JeffreyEav

Wait a minute. You claim unpaid Medicaid and Medicareto these hospitals? How? Why? And why didn't you address it? That seems like something a conservative would like to hang around big government's neck.

And you claim Obamacare policy's are not paying the hospital? So you're cool with private companies pocketing subsidies while these hospitals die?

I'm confused.

Kyle_Wingfield
Kyle_Wingfield moderator

@JeffreyEav "You claim unpaid Medicaid and Medicareto these hospitals? How? Why?"

They don't pay the full cost of care. Everyone knows that. The programs don't even pretend otherwise.

Well, Medicare kind of pretends. It claims to pay 99% of cost. But that's 99% of what's allowable, not what it actually costs. At Phoebe Worth, they write off 43% of the cost of care for Medicare patients.

So, under D.C. math, 99% actually equals 57%.

Kyle_Wingfield
Kyle_Wingfield moderator

@JeffreyEav As for this: "So you're cool with private companies pocketing subsidies while these hospitals die?"

No, I'm not "cool with" it. I've said from day one it's a terrible policy.

Kyle_Wingfield
Kyle_Wingfield moderator

@JeffreyEav Yes, it's happening. And it's done under the guise of doing something for the insured. Like I said, it's a terrible policy.

JeffreyEav
JeffreyEav

I posted twice cause I thought the computer didn't think I was being nice.

Kyle_Wingfield
Kyle_Wingfield moderator

@JeffreyEav Basically, people went from having cheap policies that didn't pay out when they needed it, to expensive policies that don't pay out until they've met a really high deductible.

Dimick
Dimick

@JeffreyEav 

It's the way the law was is written. The gub'ment says to the hospitals and doctors alike, if you are going to accept Medicare patients these are the terms you must agree to and the amounts money you shall be paid. 

Eva wonder why some doctors refuse to accept Medicare patients? 


Still confused?

Not me that's why I bought a supplemental plan F to pick up the part B excess.

By the way the supplemental  plan F will no longer be available.

Kyle_Wingfield
Kyle_Wingfield moderator

@dimik "Finally Kyle kept it real. What happen to the virtues of ACA silver plan great saving and low deductible. "

What are you talking about? Go back and read what I wrote about that. I was explaining that the deductible was so high that people pay for the plan but never benefit from having it.

Dimick
Dimick

@Kyle_Wingfield @dimik 

More ropa dope from Kyle. I'm talking about you pretending this donor law is going to address the real reason hospitals are closing. 

Stop acting dumb.  What you are praising is chump change compared to what our hospital stand in need of, got it?   

Kyle_Wingfield
Kyle_Wingfield moderator

@dimik What you wrote: "I'm talking about you pretending this donor law is going to address the real reason hospitals are closing. 

"Stop acting dumb.  What you are praising is chump change compared to what our hospital stand in need of, got it?"    

What I wrote: "The state needs a broader overhaul of health care (hint, hint, aspiring governors). This new tax credit may be rural hospitals’ best bet for surviving until that happens."

Again, make whatever point you want to make, but don't put words in my mouth.

Dimick
Dimick

@Kyle_Wingfield @dimik  Hint Hint it isn't even that. 


I'm taking in all the other dumb things you've said and wrote, as the solutions to healthcare. 

Get this Kyle, it takes a lot of money it can't be done on the cheap or by a miss mesh put together. 

Until you can bring something to the fore that can produce hundreds of millions of dollars or billions of dollars yearly for funding healthcare as I have cite again and again, you have nothing worth mentioning. 


Get behind something that will do some real good chump change given by few good soul is laudable but it does not do the job.  


JeffreyEav
JeffreyEav

I appreciate the reply. I just don't understand how a private company can take govt money and not pay a dieing hospital. That's bad policy and theft.

JeffreyEav
JeffreyEav

I appreciate the reply. I just don't understand how a private company can take govt money and not pay a failing hospital. That policy does suck.

Hedley_Lammar
Hedley_Lammar

"Collecting" in this case is better known as squeezing blood from a turnip. If they don't have the money, they're not paying. And federal law requires hospitals to treat them regardless of ability to pay.


AKA Reagancare


Wouldn't it be cheaper to provide people with insurance and gosh a primary care physician who might actually know about their health history

Kyle_Wingfield
Kyle_Wingfield moderator

@Hedley_Lammar "Wouldn't it be cheaper to provide people with insurance and gosh a primary care physician who might actually know about their health history"

Maybe you missed this part, but these are people with insurance. Obamacare insurance. It isn't working.

RafeHollister
RafeHollister

@Hedley_Lammar That was the theory used to foist Obamacare on the no nothings, save on ER visits.  Well ER visits have increased, so we now pay for both the ER visits plus the subsidies for Obamacare.

Hedley_Lammar
Hedley_Lammar

"The Electoral College is actually genius in that it brings all states, including the smaller ones, into play. Campaigning is much different!" he tweeted about a week after Election Day.


Donald Trump 2016


"The electoral college is a disaster for a democracy."


Donald Trump 2012


Better buckle up buckaroos. Gonna be a long four years with the knuckle dragger conspiracy nuts in charge.



ByteMe
ByteMe

It's a band-aid while we wait on Republican "leaders" to grow a spine.  Of course, they'll blame that they can't grow a spine on the FDA... or Obamacare.

lvg
lvg

Romney meeting with Orange Clown again tomorrow. Maybe he will get Health Secretary and convert Obamacare to Trumpcare along the Massachusetts model.

AndyManUSA#45
AndyManUSA#45

I'd hang tight until Health Secretary Tom Price has his say in it.


Private donations are a great stop gap until we fix the problems, which will not be very hard. obamacare never was about providing healthcare, obviously, it was about the government gaining control of your life and growing itself in the process. Untangle all that and give health care back to the professionals.

AndyManUSA#45
AndyManUSA#45

@RoadScholar @IReportYouWhine I think the whole point of this blog topic is that we don't have any stinkin health care, and any and all donations are welcome. It could have been titled "obama'care?'"

lvg
lvg

@IReportYouWhine ie. let the blood suckers at the big hospital chains, big pharma, the overpaid doctors and the for  profit insurance companies make a killing off people's misery.Making America Great 
Again.