CEO of HCA-owned hospital says lower share of Medicaid revenue reflects bias against for-profits

The CEO of Inverness, Fla.-based Citrus Memorial Hospital, a subsidiary of HCA Healthcare in Nashville, Tenn., said Florida hospitals under the HCA umbrella receive a disproportionate amount of Medicaid reimbursements, according to a Citrus County Chronicle report.

Citrus Memorial Hospital CEO Ralph Aleman told the Citrus County Chronicle's editorial board the government spends less on Medicaid patients in Florida than in most states, and he is seeking legislative changes to address what he describes as an inequality in Medicaid reimbursements. He called this difference an "impending crisis" and told the editorial board HCA's smaller share in Medicaid revenue reflects a bias against for-profit hospitals. HCA is Florida's largest Medicaid provider, with its 50 state hospitals receiving 18 percent of the Medicaid market.

"The dollars need to follow the patient, not the type of hospital it is," Mr. Aleman told Citrus County Chronicle. Other types of hospitals, like university and nonprofit hospitals, are at an advantage for Medicaid revenue, Mr. Aleman said.

Medicaid patients represent 13.2 percent of Citrus Memorial Hospital's admissions, while Medicare reflects 67.5 percent, commercial payers reflect 12 percent and self-pay and charity admissions total 6.4 percent.

In August, federal officials extended Florida's Medicaid managed program, know as the "low-income pool," five years. It also allocated $1.5 billion in funding to offset charity care, according to the report. While Florida hospitals can access the LIP money to pay for charity costs, Citrus Memorial Hospital has recently received zero dollars from the program, Mr. Aleman said.

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