Hocking County joins multi-county hospital funding consortium to increase Medicaid reimbursement

Hocking County commissioners voted June 5 to join a multi-county consortium that will assess participating hospitals and use the collected funds to seek additional federal Medicaid matching dollars.

County commissioners said the arrangement mirrors programs enacted in other states and counties that assess hospitals and then use those funds to draw larger federal Medicaid reimbursements. Commissioners described the arrangement as an effort to increase net reimbursement to Hocking Valley Community Hospital for patients covered by Medicaid, not as a tax on consumers.

County officials said Medicaid reimbursements at the local hospital are currently reimbursed at about 73% of cost, meaning the hospital loses money treating Medicaid patients. Under the proposed consortium model, member counties would accept a hospital assessment that the county would forward to a managing county (transcript discussion named Muskingum County as the manager in some consortium arrangements). The managing county would apply for state and federal matching funds; county officials said the expectation is the overall pool of federal reimbursement would increase and return more funds to participating counties and hospitals than the initial assessment amount.

Commissioners discussed that the program creates a short-term cash-flow obligation for hospitals because they must pay the assessment up front; county officials said hospital leaders (the hospital CEO and CFO) had endorsed the plan. In the meeting the commissioners said the approach is modeled on arrangements that began in Texas and have been used in Florida and Pennsylvania and that several other Ohio counties had already joined or were moving quickly to join.

The transcript shows the commissioners voted in favor of the resolution to join the consortium and then voted to appoint a county representative to serve on the regional board; commissioners discussed nominating the county’s representative (transcript: nomination of "Drew" to represent the county). The commissioners recorded unanimous assent on both motions in the meeting audio.

County officials said the county does not expect the assessment to be passed on to patients and described the plan as a mechanism to draw down additional federal Medicaid dollars for local hospitals. The county said administrative oversight and fund management in some consortium members will be handled by a designated county auditor acting on behalf of the consortium.