After more than a year of back-and-forth between the West Volusia Hospital Authority and area hospitals, a formal agreement has been finalized to assure hospital care for West Volusia residents who fall between the cracks in the health care system.
Now, as budgeting season approaches, the Hospital Authority approaches its next challenge: deciding who gets money.
For the deal with area hospitals, the Hospital Authority board tapped Dr. Andrew Murray, president of the Employee Benefit Management Systems miCare program, to serve as a mediator with AdventHealth and Halifax Health, which own hospitals, and EMPros, which provides doctors for emergency rooms.
Here are the terms:
The Hospital Authority agreed to set aside $1 million to pay those three entities, when they care for people who have Hospital Authority health cards. When the $1 million is gone, the hospitals agreed to continue to care for health card holders at no charge.
If the care happens in an emergency room, however, the Hospital Authority would pay for it only if the care was something the patient couldn’t have gotten at a Hospital Authority miCare clinic.
AdventHealth officials had given a thumbs-up to these new terms, which the Hospital Authority board adopted unanimously in April 2021, as had EMPros, an organization that contracts physicians. After that decision, concern abounded that Halifax would be unwilling to come to the table.
The two hospital systems had previously disagreed about payment for emergency services. By June 17, however, Murray had everyone on board.
“We’re just so excited … for this wonderful achievement,” Murray told the Hospital Authority board.
The agreement will last for three years, retroactively beginning June 1 and lasting until Sept. 30, 2024.
The board did not discuss the decision much, but member Jennifer Coen thanked Murray for his hard work, and member Judy Craig summed it up best:
“Finally,” she said.
Among the other terms, the hospitals and EMPros also agreed to a reimbursement rate of 85 percent of what Medicare would pay. EMPros and the hospitals also agreed that they would not pursue individual health card holders for payment.
With that hurdle out of the way, the Hospital Authority board can set its sights on another task board members have begun debating in recent months as budget-making season approaches: which agencies get funding, and how much.