[QUOTE=sunnyatlast;969601]Any hospital that says Medicare is paying below its costs is a bloated organization, or not telling the truth. I've run both for-profit and not-for-profit systems. We always made money on Medicare patients. Why would companies like HCA, Tenet, Florida Hospital, and Orlando Health, etc operate in FL and do so well if they could not make money taking care of Medicare patients. Now Medicaid is a different story.

Agree for sure, Also doubt if there is much indigent care done in the Villages unlike a lot of hospitals and most every patient has at least Medicare or better to pay the bills.



It says: "United Healthcare pays royalty fees to Holding Co. of The Villages, Inc." it does not say the Villages subsidizes anything..

If it weren't for these "royalty fees" required to do business in The Villages, other insurance providers might locate here. So it is really the consumer who is being hurt by this practice.

You do realize Medicare pays the Insurers big bucks each month to cover each of their Medicare Advantage customers right?

This is from 2012, probably more now.... $838 per month X 12 = $10,056.00 per year at least.
There are also other plans and special circumstances that would have CMS paying more per month on behalf of the beneficiary.


Medicare Advantage Monthly Capitation Rates for 2012 for All Plans except PACE Plans [download id="20"] showed Medicare Advantage Plans were paid $838 per month in Sacramento and $850 in Placer counties for plans with 4.0 STAR rating. In an effort to reward customer satisfaction and efficiency, reimbursement rates are also adjusted based upon the plan’s STAR rating. There are also other plans and special circumstances that would have CMS paying more per month on behalf of the beneficiary.


ALSO sunnyatlast the way you are posting makes it appear in some of your posts you are quoting me when you are not...it's your post. Thanks

IMO, The Villages Health getting in bed with UHC was a strategic mistake (although probably not a financial one) that hurts The Villages Health's reputation as well as the villagers who utilize it (you can disregard all the villages media stories about how great Medicare Advantage policies are, when in fact, the only Medicare Advantage policy The Villages Health accepts is UHC's.

[quote=sunnyatlast;969624]I would like to see the reference on that if you can locate it.

According to an interactive map of hospitals by state in this article http://www.nytimes.com/2014/06/03/bu...ased.html?_r=0
TVRH billed medicare at a rate of 0.8 times the national average in 2012.

[quote=shcisamax;969692]Here is some discussion of The Villages hospital being the highest percent Medicare in the country, highlighted in red:

Fact Finder – Medicare Dependent Hospital

The American Hospital Association annual survey of hospitals in the United States listed the total number of all U.S. registered hospitals at 5,795.

Medicare and Medicaid represent 55% of care provided by hospitals, with Medicare paying only 91 cents for each dollar spent caring for Medicare patients. 64% of hospitals are paid less than the costs of services provided to Medicare patients. The Medicare funding shortfall for hospital care exceeds $18 billion dollars.

Medicaid payment falls short of the cost of caring for Medicaid patients, with hospitals receiving an average of 86 cents for each dollar spent caring for Medicaid patients. 76% of hospitals are paid less than the costs of services to Medicaid patients. The Medicaid funding shortfall for hospital care exceeds $11 billion dollars.

When Medicare and Medicaid fail to cover their share of hospital costs, hospitals are forced to make cutbacks that affect the whole community and/or look to the privately insured to make up the difference.

Medicare Dependent Hospital

There are 86 hospitals in the country that are classified as Medicare Dependent Hospitals (MDH), (i.e. greater than 60% Medicare utilization).

Of the 86 hospitals, 14 are located in Florida. Of the 86 hospitals, TVHS has the highest percent Medicare at about 82%, making it the highest Medicare Dependent Hospital in the country for hospitals with greater than 100 beds.

The estimated shortfall in Medicare reimbursement for TVHS (i.e. reimbursement less than costs) is estimated at $5-7 million….."

The Villages Homeowners Association Fact Finder - Medicare Dependent Hospital - The Villages Homeowners Association

[QUOTE=sunnyatlast;969698][quote=shcisamax;969692]

Here is some discussion of The Villages hospital being the highest percent Medicare in the country, highlighted in red:


Where in all this was it mentioned that the developer is subsidizing anything in anyway which is where this thread started about UHC paying fees to the developer to operate here. How much indigent care does TVRH provide, did not see that mentioned either? Maybe the UHC fees should be used to make up this difference.

To be fair should not the hospitals with excessive Medicaid patients and excessive indigent care actually be compensated first??

__________________________________________________ ______________________

The Villages Health System as a MDH is campaigning Senators Bill Nelson and Marco Rubio in Washington, D.C. asking them to support the Medicare Dependent Hospital Preservation Act of 2011 as co-sponsors. This bill will put a mechanism in place to assist Medicare dependent hospitals like TVHS. Under the Act, the 86 MDH hospitals in the country would qualify for a portion of the estimated shortfall in Medicare reimbursements. For TVHS, it’s estimated $5-7 million loss would be reimbursed about 75% if the Act would be passed.

Villages who desire to support the TVHS campaign may visit a table in the main lobby of The Villages Hospital with letters to the Senators telling the TVHS story. Sample letters are available for signature and sending. TVHS will take care of mailing them to Washington, DC. Additionally, sample letters are available on the VHA website for Villagers who wish to support the MDH Act.

It should be noted that these numbers are only accurate if you assume the rates billed by the hospitals represent the actual cost of care. I don't think you will find anyone who believes that, including the hospitals.

Hospital "charges" have not reflected the cost of doing business since TEFRA changed Medicare in the mid-80s. Accounting methodologies were changed more than a decade ago to reflect the fact that patient revenue noted on the books of hospitals was a specious number. Net patient revenue correctly reflects actual reimbursement after contractual allowances (insurance discounts, Medicare and Medicaid discounts, etc) have been deducted. Some of you might be interested in looking up a hospital cost report or tax return (form 990) just for the fun of it.

I would if you'd help me read it!