GRMC explores cost-effective patient care alternatives amid Medicaid rebasing delays

During the recent FY2026 Budget Hearing held by the 38th Guam Legislature, significant discussions emerged regarding the financial challenges faced by local healthcare facilities, particularly the Guam Memorial Hospital (GMH). The meeting highlighted the pressing need for a reevaluation of hospital reimbursement rates and the potential for innovative solutions to manage patient care costs.

One of the key points raised was the high cost of keeping patients in the hospital for extended periods. A representative from GMH noted that it may be more economical to transfer patients to alternative accommodations, such as hotels, rather than maintaining them in the hospital for long durations. This approach could alleviate financial strain on the hospital, especially for patients who require long-term care.

The conversation also touched on the current reimbursement rates for GMH, which are set at approximately $1,600 per patient per day. Hospital officials indicated that a more accurate rate should be around $3,400 to adequately cover Medicare costs. They expressed frustration over delays in receiving feedback from the Department of Administration (DOA) regarding a consultant's report on Medicare rebasing, which is crucial for adjusting these rates.

Additionally, GMH officials discussed the possibility of pursuing a "critical access hospital" designation, which would allow for better reimbursement rates. However, they noted that GMH does not currently qualify for this designation due to its size, as it has over 160 beds, while the designation is intended for smaller facilities with fewer than 25 beds. This situation underscores the unique challenges faced by Guam's healthcare system, which operates in isolation compared to mainland facilities.

The meeting also marked a positive step in communication with the Centers for Medicare & Medicaid Services (CMS), as GMH representatives reported a productive dialogue with CMS officials. This engagement is seen as a critical opportunity to address the hospital's financial concerns and explore tailored solutions that reflect Guam's specific healthcare landscape.

As the legislature continues to deliberate on the budget, the outcomes of these discussions will be pivotal in shaping the future of healthcare services in Guam, ensuring that residents have access to necessary medical care without undue financial burden on the local healthcare system.