Friday, August 22, 2014

Friday, August 22, 2014

Revenues yet to recover from recession; What role should charity care play in health reform?; Charity payments in dispute at Shreveport hospitals; Common Core goes to college

Revenues yet to recover from recession
Louisiana is one of 26 states whose tax revenues have failed to recover to their 2008 pre-recession levels, reports the Times-Picayune. Revenues in Louisiana—the tax dollars that pay for health care, higher education, and public safety—are still down 13.5 percent when adjusted for inflation, according to a report from the Pew Charitable Trusts. While Louisiana is certainly not alone when it comes to lagging revenue, other states that took a more balanced approach—coupling targeted budget cuts with new revenues—are beginning to see growth that allows them to reinvest in things like higher education. Louisiana, on the other hand, has cut colleges and universities more than any other state on a per student basis, laid off more than 1,000 professors and is devoting less to critical priorities like research that help grow the economy, all while increasing tuition.

What role should charity care play in health reform?
Nationally, as millions of previously uninsured Americans gain access to health coverage due to the Affordable Care Act, hospitals are debating what role free or reduced cost charity care should play in the new coverage landscape, according to Kaiser Health News. Should hospitals pick up the tab for patients who could have bought health insurance with the help of generous tax credits, but chose not too?

Of course, in Louisiana, much of this debate is moot. Gov. Bobby Jindal has chosen to double-down on the antiquated charity care model when it comes to caring for low-income patients, instead of using available federal dollars to expand coverage. Unfortunately for the poor, health coverage is proven to increase access to preventive care, improve disease management and even reduce mortality. Charity care is better than nothing, but it is simply no substitute for coverage.

Charity payments in dispute at Shreveport hospitals
Meanwhile, back in Louisiana, LSU and the Biomedical Research Foundation (BRF)—the private partner that took over operations at the charity hospitals in Shreveport—can’t decide how much BRF owes LSU’s doctors for services provided at charity clinics. On Monday, attorneys for LSU sent BRF a bill for $25 million and demanded payment by August 27th, reports the Shreveport Times. BRF countered that it only owes $18 million and added that LSU was behind on rent owed to BRF for office space, which was putting financial stress on the hospital. Confused yet?

Of course, a dispute over $7 million in billings in nothing compared to the ongoing disagreement between Louisiana and the federal government over the use of hundreds of millions in upfront lease payments.

Common Core goes to college
Writing in the Advocate, Elizabeth Crisp observes that while sparks are flying in the state legislature and courthouses as Gov. Bobby Jindal and advocates of new education standards known as Common Core duke it out, higher education leaders have been much quieter about what the standards and the accompanying tests mean for them. Crisp notes a 2012 study that found a huge disconnect in perception of college readiness: 89 percent of high school teachers rated their students as ready, but only 26 percent of college professors felt the same way about incoming classes. The result is that large groups of students end up taking remedial courses in college.

To rectify the problem, education analysts at the New America Foundation suggest using Common Core “to streamline admissions, scholarships and college placement tests,” according to Crisp. If colleges nationwide move in that direction, it could create a problem for local institutions and students, putting an even bigger gap between Louisiana—a state with one of the lowest levels of college attainment in the country—and the states we will be competing with for jobs.

Number of the Day
13.5 percent
— Decline in Louisiana revenues since 2008, leaving less for important economic priorities like investments in higher education (Source: Pew Charitable Trusts)