Christmas Comes Early


When my boys were younger, my wife used to chastise me for getting too many presents for my two boys. Of course, the more toys I bought, the more my boys came to expect. It was a toys arms race I couldn’t win. More importantly, it was the wrong message to send to my children.

Two years ago, Tennessee hospitals began voluntarily assessing themselves on a temporary basis to bail the state out of a bad revenue situation. Of course, the more we have assessed hospitals, the more the state wants.

Once again, the THA board of directors has stepped up and given the state of Tennessee an early and significant Christmas present by indicating it would continue the hospital coverage assessment in 2012 to keep the TennCare program alive. Apparently, it isn’t enough from the state’s perspective. We were informed the state is looking at possibly cutting hospitals and other providers by another 5 percent. On top of that, other groups want THA to raise the assessment to the maximum to fund their projects.

In 2010, Tennessee hospitals’ gift to the state was $349 million, while in 2011, the bow was around a $450 million package for a grand total of $799 million in two years – all dollars the state should be paying. But the gift giving isn’t over just with the assessment. Tennessee hospitals provided another whopping $1.1 billion in uncompensated charity care costs in 2010 alone.

While THA has agreed to help fund the program this year, it will advocate to the legislature and administration that the assessment should remain at the 2011 level of 4.52 percent or be decreased. Tennessee hospitals should not be asked to increase the assessment especially when the state has seen an increase in its revenue picture. We believe some of those dollars should go towards increasing the state’s share of the TennCare program.

Congress, which in all likelihood will play the role of Grinch in the next budget round, already has stated it will reduce the allowable percentage a state can collect for these assessments. As a result of this looming uncertainty, it would be prudent for the state to keep the percentage the same as last year or lower it.

Health care is about to undergo a huge sea change. Santa might not have a full bag as he once did. Hospitals can’t be expected to continue to carry both an assessment and charity care burden.

Now that I am older, wiser and listen to my wife, my boys are down to fewer gifts. Of course, bigger boys need bigger toys, so I am not sure I am saving that much. But I do know my boys aren’t taught responsibility with more gifts.


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