File Photo - WVU Medicine Wheeling Hospital
WHEELING – WVU Medicine Wheeling Hospital, arsenic of July 1, plans to nary longer judge patients wrong the West Virginia Public Employees Insurance Agency for inpatient care, citing inadequate reimbursement to that infirmary and others astir the state.
Those reimbursement issues person deed Wheeling Hospital particularly hard, according to WVU Medicine, which spurred the decision.
Jim Kaufman, president and CEO of the West Virginia Hospital Association, announced that determination Thursday greeting connected the “MetroNews Talkline” vigor show. Kaufman said Wheeling Hospital volition proceed accepting PEIA patients for exigency attraction and volition enactment with PEIA connected continuity of attraction for PEIA beneficiaries for a definite clip frame. The infirmary decided to hold until July 1 to springiness Gov. Jim Justice and the authorities Legislature clip successful the 2023 league to hole the problem.
PEIA provides security to nationalist schoolhouse teachers and staff, authorities employees and different nationalist employees successful West Virginia.
“That is simply a immense measurement and shows you however large this situation has been,” Kaufman said connected “Talkline.”
The interest astatine Wheeling Hospital, which is portion of the WVU Medicine radical of hospitals successful the state, is that reimbursements to out-of-state hospitals dwarf those paid to West Virginia hospitals. According to a PEIA presumption this past summer, successful 2020, the bureau paid $47.8 cardinal to out-of-state hospitals for conscionable 1,903 inpatient visits, portion paying West Virginia hospitals $42 cardinal for 11,576 visits. In 2021, PEIA paid out-of-state hospitals $57.6 cardinal for 2,195 inpatient visits and West Virginia hospitals $56.3 cardinal for 12,313 visits.
PEIA’s mean outgo for inpatient services to out-of-state hospitals successful 2020 was astir 600% higher than what PEIA paid to West Virginia hospitals. In 2021, the mean was astir 475% higher.
“PEIA’s signifier of underpaying West Virginia hospitals and not covering their existent costs has had an particularly hard interaction connected Wheeling Hospital, which has mislaid $56 cardinal implicit the past 3 years,” a WVU Medicine spokesperson said successful an emailed statement. “While we had outlined our concerns to PEIA connected this taxable respective months ago, nary changes person been made.
“Nonetheless, we stay committed to moving with PEIA to alteration however it reimburses West Virginia’s hospitals,” the connection continued. “The WVU Health System is making large investments successful Wheeling to grow entree and services, but Wheeling Hospital indispensable beryllium financially viable to execute what we privation to bash there.”
Kaufman said connected “Talkline” that Wheeling whitethorn not beryllium the lone infirmary successful West Virginia to take that path, though nary infirmary has yet made a factual decision.
“I’ve been astatine galore hospitals crossed the authorities implicit the past twelvemonth and with each the fiscal challenges they’re facing … they’re looking astatine antithetic options,” helium said. “Wheeling is the first, but I bash cognize of different hospitals talking astir a akin effort.”
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