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As More Hospitals Fail, Presley Blames Reeves For Not Expanding Medicaid

Side by Side image of Brandon Presley and Tate Reeves
Democratic candidate for governor Brandon Presley, left, said KPC Promise Hospital’s closure, North Mississippi Health Services’ employee layoffs, and Vicksburg’s loss of its mental health facility at Merit Health River Region were evidence that Mississippi’s health care “system is burning to the ground.” Gov. Tate Reeves, right, has not commented on the recent cuts and closures. Photos courtesy Brandon Presley Campaign / courtesy Gov. Tate Reeves

The latest round of hospital closures and cuts suggest Mississippi’s health care “system is burning to the ground” while Gov. Tate Reeves rejects Medicaid expansion, Democratic candidate for governor Brandon Presley says.

“There is no end in sight to this crisis under Tate Reeves’ failed leadership,” he said in a July 14 statement.

KPC Promise Hospital in Vicksburg closed on June 8, Mississippi Today first reported on July 12. The next day, North Mississippi Health Services announced large-scale layoffs. On July 14, The Vicksburg Post reported that Merit Health River Region closed its behavior health unit in Warren County on June 30, transferring its 50 beds to Merit Health Central Mississippi in Jackson.

The Republican governor did not respond to an interview request for this story and has not made any public statements regarding KPC Promise’s closure, North Mississippi Health Services’ employee layoffs or Vicksburg’s loss of its mental health facility.

A May 2023 report from the Pittsburgh, Pa.-based Center For Healthcare Quality and Payment Reform estimates that 47 of Mississippi’s 74 rural hospitals are at risk of losing services, while 27 are at risk of closing.

A ‘Dramatic Shift Occurring In Healthcare’

Merit Health owned the 35-bed, long-term care facility in Vicksburg that helped hospital patients who needed more care than a nursing home could provide.

Marketing spokesperson for Merit Health Melanie McMillan told the Mississippi Free Press that the hospital system closed KPC Promise due to “back rent issues.” She wasn’t able to confirm how many employees the hospital had or if Merit offered the staff members a job at another facility.

Email to NMHS Employees July 12 2023
Read the July 12, 2023, letter North Mississippi Health Services CEO Shane Spees sent to staff.

“KPC Promise leased space on Merit Health River Region’s 6th floor. For more than a year, KPC Promise did not fulfill its contractual obligations. … No payment plans were established to resolve the outstanding contractual obligations which total more than $1.5 million,” she said in a follow-up statement to the Mississippi Free Press.

She wasn’t able to confirm how many employees the hospital had but said some former staff members now work at other Merit Health-owned facilities.

“Several former KPC Promise employees have accepted positions at Merit Health River Region and continue to care for patients in our community,” McMillan said.

Mississippi lost other health-care services in June, too. St. Dominic Hospital shut down its mental health unit on June 5. The University of Mississippi Medical Center in Jackson also closed its LGBTQ+ clinic on June 30, but that was due to political pressures, not funding problems.

“KPC Promise’s closure is the latest result of Tate Reeves’ health care crisis that continues to hurt people and kill health care jobs,” Presley said in a July 12 press release. “Tate Reeves doesn’t care if a hospital in your community closes next because he’ll always have the health care he needs. The sad thing is that while Tate Reeves fiddles, more hospitals may close soon.”

North Mississippi Health Services is laying off staff members as part of a “dramatic shift occurring within health care” that the COVID-19 pandemic “accelerated,” President and CEO of NMHS Shane Spees said in an email to staff on July 12.

NMHS’s plan may also reduce remaining employees’ hours or reassign them to another position, the email stated. Spees cited financial challenges as the reason for the changes.

“Across the country, hospitals and health systems have suffered financial losses due to rapidly increasing costs in labor, supplies and drugs,” he wrote in his email. “At the same time, what health care systems are paid to care for patients is not increasing as quickly as more and more patient care is being provided in the outpatient setting rather than within a hospital.”

Changes in Patient Payments vs Costs
Courtesy NMHS

A graph included in the email shows that, while payments per patient rose 12.31% since the pandemic began, the cost per patient rose 21.26%.

The NMHS system has six hospitals and over 100 clinics across the northeast portion of the state.

NMHS offered no further comments about how many employees are affected by the decision.

Presley: Expand Medicaid

Medicaid expansion is part of the 2010 Patient Protection and Affordable Care Act that helps cover Americans who have incomes between 100% and 400% of the federal poverty level. In the states that expanded Medicaid, those below the poverty level who are not eligible for subsidies are instead eligible for Medicaid.

But Mississippi is one of 10 states that hasn’t expanded Medicaid. Without expansion, that has left a gap for people who make too much to qualify for traditional Medicaid but not enough to qualify for federal subsidies. And it has put pressure on hospitals, which are required to see patients in emergency rooms regardless of whether they are covered or not.

“Do not settle for something that won’t solve the problem because it could potentially and only temporarily remove the liberal media’s target on your back,” Tate Reeves told Republicans as he spoke against expanding Medicaid in January 2023. AP Photo/Rogelio V. Solis

“When these individuals need health care, hospitals are required to treat them regardless of their inability to pay,” the Mississippi State Medical Association said in a statement in January. “And because these individuals are uninsured, the hospital is not compensated for necessary care. Such an economical strain on hospitals is not one that even the most successful private business could not endure.”

Despite being just 20% of the country, the states that have not expanded Medicaid make up 74% of rural hospital closures between 2010 and 2021, the American Hospital Association reported last year.

Center For Healthcare Quality and Payment Reform CEO Harold Miller said in February that Medicaid expansion would help some, but that it was not a silver bullet. The biggest problems for rural hospitals, he said, “are not due to uninsured patients; it’s due to underpayments by commercial insurers and even by Medicare.”

Reeves has long opposed Medicaid expansion, saying “free-market solutions” are the better option in his State of the State address on Jan. 30

“Instead, seek innovative free-market solutions that disrupt traditional health-care delivery models, increase competition and lead to better health outcomes for Mississippians,” he said. “Do not settle for something that won’t solve the problem because it could potentially and only temporarily remove the liberal media’s target on your back.”

Presley has been vocal about his support for Medicaid expansion since he began his gubernatorial campaign.

“As governor, I will end Tate Reeves’ healthcare crisis once and for all by expanding Medicaid which will keep hospitals open, provide affordable healthcare to 220,000 working Mississippians, and create thousands of good-paying jobs across our state,” he said.

In April, the governor signed two bills into law that approved $103 million in grants for ailing rural hospitals despite expressing some misgivings.

Reeves also called for reform to Mississippi’s certificate-of-needs laws, which require health-care providers to obtain permission before they open or expand their services. He also attributed some hospital closures or cuts to population decline.

“We are all frustrated and worried by the threats that some hospitals may close,” the governor said earlier this year. “The first step should be allowing new ones to open.”

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