The D.C. Health Department will ask for an additional $18 million to fund the D.C. Healthcare Alliance, the $80 million public-private pact that provides health care for low-income city residents.
“It’s important for us to stabilize operations of the alliance and look at how we might redesign the system, given the lessons we’ve learned,” said Health Department Director James Buford.
Mr. Buford cited increases in the number of hospitals that have joined the alliance since its creation in 2001 and a rise in reimbursement rates as cause for the overspending.
The D.C. Council will consider the $18 million request next month. Overall, the D.C. government was projected to spend about $97 million on the alliance in fiscal 2003, which ended Sept. 30, officials said.
At a news conference yesterday, Mr. Buford outlined several changes in how the alliance will operate in its third year.
The health official said the alliance will continue to reimburse hospitals under a “presumptive eligibility” policy to cover services provided by alliance members to individuals who do not belong to the pact.
The alliance will pay member hospitals for care “over and above” amounts that exceed hospitals’ charity care budgets, officials said. Also, hospitals will not be reimbursed for services provided to individuals who should have been covered by Medicaid or who do not live in the District, Mr. Buford said.
Hospital officials yesterday said they had not been given advance copies of Mr. Buford’s proposal and could not comment on his recommendations.
“It’s disingenuous to say the least,” said Robert Malson, chief executive officer for the D.C. Hospital Association. “If this plan is as great as Mr. Buford said it was, why wouldn’t he share it with the hospitals first?
“The plan may be great, but we just don’t know right now. It sounds like there could be some good things in it,” Mr. Malson said. “But it would have been helpful if we had been given a chance to read it.”
Mr. Buford said that while hospitals are an important part of the alliance, its officials need to return to their original mission of providing primary and preventive health care. “This is not intended to be a hospital-based program,” he said.
The fate of troubled Greater Southeast Community Hospital will not doom the alliance, Mr. Buford said. Greater Southeast, the primary facility for the District’s poor, filed for bankruptcy last year and now operates under a provisional license after city health inspectors found deficiencies in fire safety, staffing and anesthesia care.
“We support the presence of a strong hospital that will serve the residents of Wards 6, 7 and 8,” Mr. Buford said.
City health inspectors will decide Oct. 12 whether to restore the hospital’s license or close the facility.