ODESSA, Texas — Rural hospitals in Texas have struggled with funding over the last decade or so, as prices continue to rise with reimbursement rates staying the same or doing the opposite.
Uncompensated care must be performed for patients if they are uninsured or simply cannot cover the medical expenses by themselves, leaving these hospitals to cover the cost, typically without enough outside financial support.
It is a problem in more rural communities of West Texas, although oil revenue has helped property values, ultimately allowing some hospitals to cover the cost of that uncompensated care through tax support.
However, for those less fortunate across the lone star state, leaders are looking for other avenues to better health care in rural areas, with federal Medicaid expansion into Texas still unlikely.
The Texas state legislature has enhanced state Medicaid rates over it’s last two sessions, but there are reasons preventing the state from welcoming federal Medicaid expansion.
“Borrowing money at the federal level that we don’t have, and with federal programs like Medicaid there tend to be a lot of strings attached and one size fits all," said John Henderson, President and CEO of the Texas Organization of Rural and Community Hospitals. "So, I think the leaders, in the senate particularly, and the governor’s office prefer a Texas-specific solution, and probably more of a free market solution."
The state of Texas leads the nation is uninsured patients at just under 20%, a reality that forces rural hospitals to bear the burden for medical expenses.
Without federal Medicaid expansion, there is another option for rural hospitals to care for uninsured patients with financial gain.
“We are, and every hospital is able, to provide quality care to uninsured patients with the expectation that we can access those federal charity dollars from uncompensated care," said Jim Horton, CEO of the Rankin County Hospital District. "So, there are ways to get paid for uninsured patients."
One other avenue in trying to better health care in West Texas is by increasing funding for college and university faculty to teach the next generation of health care providers.
“If we can add state funding to make these teaching positions for nurses more lucrative, that can help fill and stop this nursing shortage that we’re seeing in West Texas and throughout the state," said Odessa State Representative Brooks Landgraf.
“This is an all-hands-on-deck type of situation," said Landgraf. "We want to make sure that they have the resources to hire and equip teachers who can properly train a new generation of excellent nurses, who will then serve – not only in our communities in Odessa and Midland – but in other communities throughout West Texas.”
Landgraf also said that they are working on a Medicaid block grant program that would better serve health care and taxpayers in Texas.
He mentioned the importance of continuing funding for expanded broadband coverage to allow more Texans to access telemedicine and online health services.