Final
Health Care Environment in Colorado
HEALTH CARE TASK FORCE
Votes:
Action Taken:
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12:03 PM -- Discussion of a Variety of Issues Related to the Health Care Environment in Colorado
Larry Wall, President, Colorado Health and Hospital Association, talked about a variety of health care issues touching specifically on the reporting of hospital infection rates. He distributed four handouts: 1) a report on Colorado Hospital Quality (Attachment D); 2) a powerpoint presentation entitled "An Analysis of Community Benefits of Colorado Hospitals" (Attachment E); 3) a report on Colorado Hospital's Operating Expenses (Attachment F); and 4) a report on "The Cost of Caring: Sources of Growth in Spending for Hospital Care" (Attachment G).
Representative McCluskey asked Mr. Wall to expound on the chart in his packet that addresses infection rates across Colorado. Mr. Wall talked about a national effort that is going on to reduce the number of deaths from infections in many hospitals across the country. This data will be reported nationally, and this data will be available to the public. The effort is just starting.
12:14 PM
Mr. Wall talked about workforce shortage issues in Colorado. He added that workforce issues are increasing in Colorado and will create additional problems in the future in the provision of health services. He stated that the nursing shortage is large, but that pharmacists, medical technologists, and radiation technologists are also experiencing big shortages in Colorado and nationally.
Representative Butcher asked what is being done to address the shortages, adding that nurses are doing tasks such as changing bed pans that should fall to other hospital staff. She discussed other problems that are also effecting workforce issues such as not providing full-time employment opportunities and the long waiting lists at nursing schools. Mr. Wall responded stating that he agrees with Representative Butcher's assessment of the issues, but added that this problem is bigger than what the hospitals alone can solve, rather it seems to require a strong public private effort to address these issues.
Senator Tochtrop commented on the nursing shortage issues as well. Mr. Wall responded to the committee's questions about other outreach efforts hospitals are undertaking such as a hospital in northern Colorado that has provided a PhD nurse to assist in the education of graduate level nurses at the University of Northern Colorado. The committee continued to discuss the nursing shortage, and talked about how the Board of Nursing also needs to be brought into the discussion of this issue.
12:33 PM
Mr. Wall discussed a study that was done on the issue of community benefit of Colorado hospitals (Attachment E). He stated that he was not going to address the whole presentation, rather he directed the committee to the pages that deal with hospital reimbursement rates and charity care. He touched on high deductible plans and bad debt, and stated that these components result in cost shifting that was discussed earlier in the meeting. He also talked about the impact that the uninsured population has on bad debt and cost shifting.
Senator Keller asked about current law related to hospital special taxing districts. Mr. Wall stated that there are 18 public hospitals in the state, and some county hospitals, and added that many of these entities have taxes in place to support the facilities. He also stated that a bill passed in 2005 allows mental health facilities to impose taxes for funding as well.
12:40 PM
Mr. Wall discussed a document that was prepared for the Joint Budget Committee (Attachment F) that addresses operating expenses for hospitals in Colorado, and Medicaid payments as a percentage of costs. He also commented on an upcoming 4.6 percent reduction in Medicare reimbursement rates that he fears will drive more physicians away from serving Medicare patients thus driving patients into the emergency departments of hospitals.
Representative Butcher asked whether there are clinics that specifically work with indigent persons rather than having the hospitals deal with them. Mr. Wall stated that there are these types of facilities in Colorado; however, if the patient goes first to the emergency department, triage services and an evaluation (under federal law) must be conducted before they are transferred to the clinic, so cost is still incurred. He added that if people went directly to these clinics, some of these problems would be addressed.
Representative Frangas and Mr. Wall discussed the problems with serving Medicaid patients including the heavy paperwork burden.
12:55 PM
Mr. Wall commented on the final handout (Attachment G) which provides an overview of what is driving costs in hospitals.
12:57 PM
Recess.