LRGHealthcare moves to trim cost of HealthLink Services program

LACONIA — LRGHealthcare this week announced measures to trim access and raise co-pays for HealthLink Services, all designed to reduce expenses to offset shrinking operating revenues and rising tax liabilities as the result of changes in the Medicaid program made by the state and federal governments.

LRGH indicated that adjustments to the HealthLink Services would be forthcoming last year when it joined nine other hospitals in challenging the changes made to the Medicaid program in the 2012-2013 state budget. The changes to the program will take effect on March 1.

HealthLink effectively provides health insurance to those who fail to qualify for Medicaid. Currently there are four plans serving households according to their size and income as a percentage of poverty, each with different co-pays: "A" for those with earning up to 185-percent of poverty, "B" for those earning between 186-percent and 225-percent of poverty, "C " for those earning between 226 percent and 325-percent of poverty and "D" for those earning up to 375-percent of poverty. Enrollment in the program spares both the patients and the provider the burden of repeatedly applying for financial assistance to meet the cost of medical services.

Beginning in March the four plans will be collapsed into three. The eligibility requirements for Plans "A" and "B" will remain the same while Plan C will be open to those earning between 225-percent and 300-percent of poverty.

The co-pays for hospital inpatient services are $200 for Plan A, $500 for Plan B and 10-percent up to $1,200 for Plan C.

The average stay at Lakes Region General Hospital is 4.57 days at a cost of $27,334.

The co-pays for hospital outpatient surgical services are $100 for Plan A, $250 for Plan B and 25-percent up to $1,000 for Plan C.

The co-pays for hospital outpatient services are the lesser of the actual charge or $50 for Plan A and $125 for Plan B and the lesser of half the actual charge up to $500 for Plan C.

The co-pays for hospital emergency services are $120 for Plan A, $160 for Plan B, and $200 for Plan C.

Henry Lipman, senior vice-president and chief financial officer of LRGH, said "we are still determined to provide charitable care, but some adjustments are required to mitigate the financial pressures weighing on us." He added that the adjustments to the schedule of co-pays are calibrated to reflect the actual costs of medical services to the community at-large.

Lipman said that LRGH continues to pursue operating efficiencies in an effort to reduce costs, but noted that health insurance carriers have become increasingly resistant to bearing a share of the cost of charitable care.

Last October, Wentworth-Douglass Hospital in Dover and Frisbee Memorial Hospital in Rochester took similar measures. Both hospitals had provided charitable care to patients with incomes up to 300-percent of poverty and both limited eligibility to those earning up to 200-percent of poverty.