Lipman urges Medicaid expansion; speaks at hearing on behalf of N.H. Hospital Association

CONCORD — Speaking on behalf of the New Hampshire Hospital Association, Henry Lipman, senior vice-president of financial strategy and external affairs at LRGHealthcare, last week told the commission studying the expansion of the Medicaid program that extending enrollment "is the right thing to do for our patients and our state."

Lipman, who chairs the Advocacy Task Force of the association, said that as he was speaking someone without insurance who would be covered if the program is expanded is being treated for a chronic condition in an emergency room because they have no where else to turn. Taking the opportunity to extend Medicaid offered by the Affordable Care Act, he said would ensure that people "get the right care, at the right time and in the right place."

Between 2008 and 2011, Lipman said, that cost to hospitals of providing uncompensated care to uninsured patients climbed 40-percent, totaling $550-million, adding that a share of that cost is reflected in higher insurance premiums individuals and employers. "That is simply not sustainable," he said.

Insurance, Lipman stressed, provides regular access to primary and preventative care, without which medical services cannot be delivered appropriately or efficiently. Without the access that an expansion of Medicaid would provide the care of those patients will remain "unmanaged, uncoordinated and consuming far more resources than necessary.

The association, Lipman told the commission, surveyed approximately 100 physician practices owned by hospitals that serve more than 500,000 patients. Almost all are open to new Medicaid patients and plan to accept more if the program is expanded.

Lipman discounted the projection of the Lewin Group that net revenues to hospitals would rise by $113 million if Medicaid is expanded, but by $158 million if it is not, a difference of $45 million. He cited several factors that suggest that while net revenues will increase under both scenarios the difference will not be nearly as great as the Lewin Group estimates.

Finally Lipman said that despite the expansion of Medicaid, an uninsured population will remain and hospitals will continue to provide uncompensated care. Consequently, the so-called disproportionate share (DSH) program, which distributes funds to those hospitals serving relatively greater numbers of indigent patients, will continue.

The Hospital Association was echoed by a number of other organizations representing health care providers in supporting the expansion of the Medicaid program, among them the New Hampshire Community Behavioral Health Association, which includes Genesis Behavioral Health.