Hocking County commissioners join hospital consortium to pursue tax-based Medicaid matching funds

Hocking County commissioners voted on Thursday to join a multi-county consortium that will assess a tax on participating hospitals and use the collected funds to increase Medicaid reimbursement dollars, and they appointed a county representative to serve on the consortium.

A commissioner described the model as already used in other states — notably Texas and Florida — and said the program’s purpose is to pool locally collected hospital taxes as state/local contributions that can be used to draw additional federal Medicaid matching funds. The presenter and other commissioners said the program does not change patient billing and, in their description, the hospital itself pays the tax to the county, which then participates in a matching scheme intended to generate more federal Medicaid dollars for the hospitals.

Why it matters: Commissioners said the county’s hospital receives about 73% reimbursement on Medicaid patients, which can leave hospitals operating at a loss on those encounters. The consortium is intended to increase the funds available to match federal Medicaid dollars and improve hospital reimbursement rates.

At the meeting the board approved a resolution to join the consortium and then appointed a county representative (referred to in the record as “Drew”) to serve as the county’s delegate to the group that will administer the program. The meeting record shows a roll-call vote recorded for the resolution reading the names in the transcript as follows: “Sandra Davidson? Yes. Jason Denofrio? Yes. Michael West? Yes.” Commissioners then approved the appointment of Drew; a motion to second the appointment was entered and the motion carried by voice vote.

Discussion in the meeting included references to other counties that have adopted similar arrangements, the role of a lead county auditor or fiscal agent to manage funds and apply for federal reimbursements, and the hospital CEO and CFO’s endorsement of the plan as presented in the meeting. One commissioner noted this will be a short-term cash-flow issue for participating hospitals because they must pay the tax upfront while awaiting federal reimbursement; another commissioner emphasized the board was acting to protect local hospital services.

The board also discussed timing: proponents said they wanted the consortium agreement in place quickly to meet budget and implementation timelines and cited approvals already in three counties.

Clarifying details: The motion referenced a draft resolution modeled on documents provided by counsel familiar with the approach in Florida; the county’s role would be to adopt a resolution and appoint a representative to the consortium board. The transcript records the hospital CEO and CFO as endorsing the program, but their names were not read into the record during discussion.

No ordinance or county tax rate was approved at the June 5 meeting; the board’s action was to join the consortium and appoint a county representative to the group that will administer the program. Implementation, oversight and exact tax mechanics were described in general terms at the meeting but will require subsequent implementing agreements and administrative steps.