LOCAL ECONOMIC SNAPSHOT | MEDICAL COSTS

Paying for the poor’s health care
By JASON ROBERSON
Staff Writer jroberson@dallasnews.com

KYLE ALCOTT
Staff Artist kalcott@dallasnews.com

The following charts give a picture of how much Texas hospitals depend on government funding to pay the cost of serving poor and uninsured patients. Uncompensated care information is obtained from a hospital’s Medicare cost report. Costs are estimated based on a hospital’s gross charges and overall cost-to-charge ratio. The reports from individual hospitals are voluntary, which explains why some big hospitals like John Peter Smith in Fort Worth are not included.

Cost of government programs
While federal and state governments reimburse hospitals for caring for poor and indigent patients, the revenue rarely covers the actual cost. The top 10 hospitals in North Texas ranked by the cost of administering government health care programs:

(All figures in millions) FACILITY Parkland Memorial Hospital (Dallas) Baylor University Medical Center at Dallas Texas Health Harris Methodist Hospital Fort Worth Texas Health Presbyterian Hospital Dallas Baylor All Saints Medical Center at Fort Worth Good Shepherd Medical Center (Longview) Methodist Dallas Medical Center Baylor Medical Center at Irving University of Texas Southwestern Medical CenterSaint Paul (Dallas) Medical Center of McKinney

MEDICAID REVENUE $190.51 $218.59 $73.86 $11.59 $113.94 $29.99 $18.22 $13.03 $11.92

MEDICAID COST $256.77 $69.21 $50.77 $49.79 $38.26 $27.35 $27.21 $18.11 $17.76

TOTAL GOVERNMENTAL PROGRAM REVENUE $637.4 $218.8 $73.9 $11.6 $124.4 $31.1 $18.2 $13 $11.9

TOTAL GOVERNMENTAL PROGRAM COST* $617.6 $69.5 $50.8 $49.8 $48.4 $29 $27.2 $18.1 $17.8
* Includes SCHIP and care for the uninsured, but excludes Medicare.

$24.27

$13.93

$25.3

$15

Revenue from Medicaid
North Texas’ 10 largest hospitals ranked by percentage of revenue coming from Medicaid: FACILITY Parkland Memorial Hospital Baylor All Saints Medical Center at Fort Worth Medical Center of McKinney Texas Health Presbyterian Hospital Dallas Texas Health Harris Methodist Hospital Fort Worth Methodist Dallas Medical Center Baylor University Medical Center at Dallas University of Texas Southwestern Medical Center-Saint Paul Denton Regional Medical Center Texas Health Presbyterian Hospital Plano
SOURCE: American Hospital Directory

How Parkland stacks up against other large county-operated hospitals
Percentage of total revenue coming from Medicaid: FACILITY CITY PERCENTAGE Maricopa Medical Center L.A. County/University of Southern California Medical Center Kings County Hospital Center Jackson Memorial Hospital Parkland Memorial Hospital John H. Stroger, Jr. Hospital of Cook Co. Erie County Medical Center Ben Taub General Hospital Phoenix Los Angeles 53% 51%

CITY Dallas Fort Worth McKinney Dallas Fort Worth

PERCENTAGE 32% 12% 11% 11% 10%

Brooklyn, N.Y. Miami Dallas Chicago Buffalo, N.Y. Houston Atlanta Charlotte, N.C.

44% 34% 32% 31% 25% 25% 23% 18%

Dallas Dallas Dallas

10% 10% 6%

Denton Plano

5% 4%

Grady Memorial Hospital Carolinas Medical Center

The bottom line
“No hospital in Texas, including Baylor, makes money on indigent care. Not accounted for here is the care we provided to some of the 28% of Texans without any government coverage. Baylor Dallas lost $63 million dollars caring for the indigent last year.” John McWhorter, president, Baylor University Medical Center “The numbers reflect that Parkland is one of the largest Medicaid providers in the state and we are not reimbursed by our full cost by Medicaid. Medicaid only pays about 70% of our total cost.” John Dragovits, chief financial officer, Parkland Memorial Hospital “In an effort to fix the state budget lawmakers are considering cutting Medicaid reimbursements. Take a look at the chart ranking hospitals by percentage of Medicaid revenue. Now think in terms of your own family budget. Few of us could afford for someone to tamper with 10 to 40 percent of our yearly revenue.” Jason Roberson, reporter, The Dallas Morning News

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