Hospitals struggle in Kansas, Louisiana and Kentucky

Some woes hinge on lack of Medicaid expansion
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Kentucky, Louisiana and Kansas are in different parts of the country, but the disparate states all have something in common: Hospitals that are on the brink of financial disaster.

More than half of Kentucky's rural facilities rank below the nationwide average in terms of financial strength, and fully a third were considered to be in poor financial health, the Louisville Courier-Journal reported, citing a new report issued by state officials. Rural hospitals in the Bluegrass State serve about 45 percent of its total population and a large share of impoverished and older residents.

However, Gov. Steve Beshear criticized the report because it did not include any data from 2012 and beyond, when Kentucky became one of the few red states to expand Medicaid eligibility. The state's hospitals received $506 million more in Medicaid payments last year than they had prior to the expansion, according to the Courier-Journal.

Medicaid expansion has been tied to drops in uncompensated care for hospitals, FierceHealthFinance has reported. 

Kansas has been dead-set against expansion, as lawmakers have either voted it down or stalled committee votes altogether. That's prompted at least a couple of hospitals to seek operational partners, while others are in danger of closing, according to the Kansas Health Institute News Service. To date, the Kansas Hospital Association believes as much as $475 million in additional Medicaid payments have been lost, according to the KHI News Service.

In Louisiana, the state privatized the public hospital system once operated by the Louisiana State University in 2012, with several companies taking over their operation. However, the operators are dependent on receiving more than $330 million in base funding financed on tax payment, and lawmakers may balk at passing those taxes, the Shreveport Times reported. The potential shortfall may be enough to allow the private operators to legally opt out of their contracts.

"It could break up a lot of hospitals," State Sen. Francis Thompson told the Shreveport Times. "If we don't have enough funds, we face the option of losing partners that are doing a good job."

But even if those payments materialize, the private operators say the money budgeted for the public hospitals is still $142 million less than what is required to operate them properly.

To learn more:
- read the Louisville Courier-Journal article 
- check out the KHI News Service article 
- here's the Shreveport Times article

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