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CONCORD, NH – Hospitals in New Hampshire are continuing to see an increase in the number of patients who are unable to pay for their care.
A survey from the New Hampshire Hospital Association indicates the economic crisis is continuing to have a negative impact in the state, in that a higher proportion of hospital patients are covered by public assistance programs than in 2010 and more hospital systems are operating in the red.
"Community need for care remains high, and in tough times people in our communities turn to their local hospitals," said Michelle McEwen, chairwoman of the NHHA's board of trustees and CEO of Speare Memorial Hospital in Plymouth, N.H. "Hospitals face a difficult challenge trying to balance the growing needs of their communities with economic circumstances."
The survey was sent to all 26 New Hampshire community hospitals in November 2010, and 25 hospitals responded. It was modeled after one conducted nationally by the American Hospital Association.
The NHHA found that nearly all of the hospitals surveyed made various changes to cope with mounting financial stress. Ninety-five percent of hospitals surveyed took steps such as reducing services, freezing wages, reducing employee benefits and cutting staff – the same percentage as reported in two previous surveys.
The majority of New Hampshire's community hospitals – 52 percent - are seeing more patients without insurance coming through their emergency departments, and the number of hospitals which reported that increase as "significant" rose by 16 percentage points.
Forty-eight percent of the acute care hospitals saw a significant or moderate increase in the number of patients covered by Medicaid and other public programs for New Hampshire's low-income populations.
NHHA president Steve Ahnen said the survey confirms that the state's hospitals are treating an increasing number of low-income patients even as the recession has – in some eyes – begun to ease.
"In a weak economy, hospitals' role as part of the healthcare safety net in New Hampshire is more important than ever," Ahnen said.
The NHHA survey also found that many hospitals' financial measures are still showing signs of strain.
Thirty-two percent of hospitals report a moderate to significant decrease in "days cash on hand," an increase from 28 percent the year before, while 40 percent are experiencing a significant decrease in operating margins, compared to 24 percent in April 2010.
Things won't likely get much easier in the near term for New Hampshire hospitals, as Gov. John Lynch wants to make significant cuts to Medicaid disproportionate share payments to hospitals.
In testimony before the state Legislature, Leslie Melby, the NHHA's vice president for state government relations, said the cuts would be "unsustainable."
"If the cuts proposed are put in place, the impact will be felt by all New Hampshire citizens ... not just those covered by Medicaid," she said.