Manatee County is pivoting as Manatee Memorial cuts back on indigent care


Manatee Memorial Hospital is cutting back on care for indigent and uninsured patients, with an exception for emergency room visits to meet legal obligations.

The for-profit hospital notified stakeholders on May 6 that, effective June 1, it will no longer accept patients enrolled in Manatee County’s health plan, known as Good County, or unfunded referrals from the nonprofit We Care Manatee. Normally there are between 1,800 and 2,200 patients. individuals who have enrolled in the Good County program at any time.

“Our projected shortfall in unfunded care, excluding charity care, is several million dollars,” Manatee Memorial announced in the unsigned letter. “The significant costs of unreimbursed care are unsustainable. We remain a supportive community partner and will have open conversations with Manatee County about solutions, but we must make this difficult, yet responsible, fiscally sensible decision.”

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The decision leaves Manatee County and local health care providers to fill gaps in services for indigent or uninsured residents, and there are concerns that some surgical patients will be left without options.

“I literally just got off the phone with one of our patients,” said Shannon Hoyt, executive director of We Care Manatee. “She is in very poor health and has been working with our doctors, and there are times when she requires surgical intervention to help her breathe. She had one planned and now she can’t go. We had to tell her to go to the emergency room and hope they will see her.”

Manatee Memorial seeks funding, but Manatee County turns around

Manatee Memorial Hospital CEO Tom McDougal announced plans to end indigent care services unless Manatee County agreed to a significant increase in funding during an April 16 public county commission meeting focused on local impact of illegal immigration.

During the meeting, McDougal addressed the low amount of provincial funding for indigent and uninsured care and indicated that no new deal had been reached for services in 2024 and beyond. He estimated that it cost the hospital $21.2 million in 2023 to provide charity, indigent and uninsured care, and another $2.9 million in uncollectible care, while receiving only $2.7 million in funding from Manatee County .

Instead of increasing funding, Manatee County decided to move to a community-based model focused on preventative care. Commissioners will consider a resolution for that option at a county meeting scheduled for June 11.

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“The resolution will allow us to expand to new providers,” said Manatee County Health Information Services Manager Geoffery Cordes. “It really takes the medical home lens from primary care to where we’re going to direct people to the least expensive, most appropriate facility within the community, which will then manage that care and direct it to specialty providers.”

“In the meantime, for elective surgeries, we’ve been working with the Federally Qualified Health Center to help us navigate some of that. That’s MCR Health,” he said. “Then we are obviously looking for additional community partners.”

Cordes added that the Good County program also has case managers who actively work to help patients enroll in commercial or market-based health insurance programs.

Hoyt said We Care Manatee — one of about 30 to 40 practices and organizations using Good County funding — is in the middle. The nonprofit serves clients enrolled in the Good County program, but also receives funding from donations, grants and other sources.

“The hospital makes its decisions, and I understand they make business decisions, but I don’t think they understand the consequences,” Hoyt said.

“We understand that sometimes people go through tough times and sometimes they don’t have insurance, and sometimes it’s life or death,” she said. “We save lives every day and we will continue to do so, and we have to think outside the box.”

Bradenton approves special assessment of hospitals

Manatee Memorial Hospital approached the City of Bradenton for assistance in obtaining additional Medicaid and indigent care funding. The City Commission obliged by unanimously passing an ordinance to impose a special assessment on properties within the city limits owned by for-profit and non-profit hospitals.

By collecting that tax, the hospitals become eligible to receive federal dollars to supplement Medicaid payments and indigent care costs, a net benefit according to Colleen Ernst, executive vice president of Adelanto Healthcare Ventures, who presented on behalf of the hospital at the meeting.

“The state has historically only allocated so much money for hospitals to receive about 60 cents on the dollar in Medicaid reimbursement, and for charity care costs it is about 1% for many health care providers in the state,” Ernst said. “By collecting the dollars in a special assessment, those dollars become eligible for federal matching funds here.”

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“It’s certainly not a very generous amount, but it’s enough to give them more than the 1% they get for charity care,” she said. “In Medicaid, we’re going to see a big difference… Instead of getting 60 cents on the dollar, the hospitals could get about 80 cents on the dollar. So what this actually does is it reduces the losses for that type of care.”

Ernst emphasized that Medicaid is one of the largest providers for reimbursement for births, and said that in Florida, more than half of all births in Florida are funded by Medicaid.

“So you can imagine expensive procedures, where you only get 60 cents on the dollar, while hospitals don’t have the ability to access these types of resources, often very difficult trade-offs are made. This program is one of the ways help close that reimbursement gap and ensure hospitals can cope with that financial landscape.”