Mississippi doctors, hospitals take different stands on Medicaid expansion

JACKSON, Mississippi — With a legislative showdown expected any day now over expanding Medicaid to about 300,000 of the state’s uninsured working poor, the Mississippi State Medical Association has declared that Mississippi’s uninsured deserve medical care but cautioned “a Medicaid expansion may perpetuate a broken system.”

Mississippi State Medical Association President Dr. Steve Demetropoulos worries hospitals would endure huge hardships over the loss of money for treating the uninsured.

Mississippi State Medical Association President Dr. Steve Demetropoulos worries hospitals would endure huge hardships over the loss of money for treating the uninsured.

The official MSMA statement is clear in expressing what it says are the anxieties of the state’s physicians that Medicaid expansion would jeopardize an-already troubled health care delivery system in which Medicaid now covers 644,000 low-income, needy or disabled Mississippians.

The MSMA’s worry is nearly opposite that of the Mississippi Hospital Association. The association made up largely of hospital and health care executives says disastrous consequences could befall the state’s hospitals once the federal government shifts money from paying hospitals to cover treatment of the uninsured to expanding Medicaid in the states that participate in the expansion.

In a statement issued last June just after the U.S. Supreme Court ruled that states can opt in or out of Medicaid expansion under the Affordable Care Act, the Mississippi Hospital Association predicted that rejecting the expansion would spell “devastating” consequences for uninsured Mississippians and hospitals alike.

“Failure to expand Medicaid eligibility will leave just under 200,000 Mississippians with no health care coverage at all,” the MHA said in detailing its position.

“These Mississippians will be left ‘in the gap’ – not eligible for Medicaid and not eligible to purchase health insurance through the health insurance exchange. The result could be devastating. Hospitals cannot be expected to treat such a large volume of people with no expectation or prospect of payment for those services. The result could very well mean the closure of many of our community hospitals.”

By contrast, the Mississippi State Medical Association official statement predicts huge harm could come from Medicaid expansion:

“Mississippi physicians believe all uninsured patients in Mississippi deserve medical coverage; however, physicians have concerns that a Medicaid expansion may perpetuate a broken system. Physicians fear that an expansion of Medicaid may not be financially sustainable and will impose on the State unintended consequences that will weaken provider capacity which is inadequate now and will worsen. We are concerned that the State is not prepared to handle those immediate and future consequences.”

Meanwhile, the expansion issue has been in a partisan stalemate for weeks. Democrats in the Mississippi Legislature have refused to extend Medicaid past July 1 without an expansion. Republicans, led by Bryant, say the tens of millions of dollars the state would have to come up with to cover its share of the expansion would be a quick ticket to bankruptcy.

The likelihood of a special session next week on Medicaid grew this week with a new legal opinion from Attorney General Jim Hood. The AG insists that the governor can’t authorize Medicaid payments beyond July 1 without legislative approval.

The non-binding opinion from Hood, a Democrat, contradicts Republican Bryant. The governor has said for weeks that he thinks he can run the program himself, even if lawmakers don’t vote to keep it alive beyond June 30, the end of the current budget year.

Hood wrote Wednesday that without legislative action to keep Medicaid in business beyond July 1, “the Division of Medicaid and the position of its executive director will no longer exist.”

Bryant is in Europe this week and unavailable for comment, the Associated Press reported.

While the Mississippi State Medical Association is clear in expressing the harm that could come from greatly enlarging the state’s Medicaid rolls, the association’s president is a bit less emphatic in his public objections to growing Medicaid.

Dr, Steven L. Demetropoulos, MSMA’s 2012-2013 president, emphasized in the April JOURNAL MSMA that emergency rooms around the state serve as a primary health care source for many of the working poor who would be covered under the Medicaid expansion. Keeping low-income workers off the Medicaid rolls and forcing them to rely on emergency rooms and federally funded free clinics around the state will put tremendous financial stress on the state’s entire health care system, wrote Demetropoulos, an ER physician at Pascagoula’s Singing Rivers Hospital.

A significant portion of the stress would come from the loss of federal disproportionate share, or DSH, payments the hospitals receive to cover at least some of the cost of treating uninsured people, Demetropoulos said.

Just this year, the state’s hospitals received around $155 million in federal DSH payments. The Mississippi Hospital Association projects reimbursement cuts could total $5 billion over the next 10 years, based on current provisions of the Affordable Care Act.

“It is vital for those hospitals to maintain their bottom lines,” Demetropoulos said in a press statement Thursday, referring to the importance of the reimbursement money.

“If a hospital is not duly paid for the care they give, this could mean reduction of access to care, testing, and any other services the hospital provides.”

The federal government has agreed to wait until after 2015 to initiate a phased lowering of the amount disbursed nationally in DSH payments. The original plan specified a lowering of payments nationwide by $5 billion in 2015 before lowering the total DSH care payments by $20 billion in 2020. Presumably, the U.S. Department of Health and Human Services will return to that schedule after the 2015 reprieve.

Addressing the state’s mandated share of Medicaid expansion – which he estimated would be $159 million by 2025, Demetropoulos wrote in the JOURNAL article: “Some people would say this is an impossible number for the state to reach inasmuch as we already are having difficulty funding our current Medicaid budget, which was $30 million over budget this year alone.

“Others would say, ‘If I come up with $1 and you would give me $9, then I would take that match any time.”

Demetropoulos noted that economics projections say Medicaid expansion would create about 8,000 new jobs. “Some people have gone so far as to say that if the state were trying to recruit a business into the area and it would have to come up with $159 million each year but the business would generate $1.2 billion, [the state] would be clamoring to take on that extra money.”

In an “on the one-hand-and-on-the-other-hand” approach used throughout his article, Demetropoulos said others argue that providing the working poor with free medical care would diminish their sense of responsibility. Further, he said, others argue:“If they do not have to pay anything for these services then they don’t really value them.”

Another worry raised, he said, is the lack of sufficient primary care physicians to handle a massive influx of new people into Medicaid.

Alternatives that others have suggested, he said, include covering the working poor through some type of health insurance exchange or providing plans offering high deductibles or tax credits.


Mississippi 5th nationally in business startup activity

payday loan pic4_f3fb48472d(2)Mississippi is ranked 5th nationally in the most business startup activity in 2012, according to the Ewing Marion Kauffman Foundation Index of Entrepreneurial Activity.

Mississippi had a startup rate of 430 per 100,000 adults. Montana leads the list with 530 startups per 100,000 adults. Others in the Top 10 are: 2. Vermont, 3. New Mexico, 4. Alaska, 6. California, 7. Idaho, 8. Hawaii, 9. Louisiana, 10. Nevada.

A summary on CNNMoney.com says:

“Small businesses have long been a cornerstone of Mississippi’s economy, since few large corporate headquarters or R&D facilities are based here. Indeed, many new college grads choose to start their careers by launching a business, said Tony Jeff, CEO of Innovate Mississippi, a nonprofit that helps early-stage companies.

“Startups can get help doing research and finding capital through Mississippi State University’s Entrepreneurship Center. They also can enroll in business-training bootcamps offered throughout the state by the Mississippi Development Authority.

“Many entrepreneurs are drawn to the state’s growing telecom, tech, oil & gas, and biomass energy industries.

“Meanwhile, cost-conscious entrepreneurs find Mississippi’s modest costs appealing. Living here is cheap, low salaries keep payroll costs down, and personal income and business tax rates are far below the national average.”

The Kauffman Index of Entrepreneurial Activity describes itself as a leading indicator of new business creation in the United States.

It describes the process as “capturing new business owners in their first month of significant business activity, this measure provides the earliest documentation of new business development across the country. Analysis of matched monthly data from the Current Population Survey (CPS) allows for comparisons of the percentage of the adult, non-business owner population that starts a business over time. In addition to this overall rate of entrepreneurial activity, separate estimates for specific demographic groups, states, and select metropolitan statistical areas (MSAs) are presented. The Index provides the only national measure of business creation by specific demographic groups.”



New road opens at state’s largest research park

The Technology Blvd. entrance to the Thad Cochran Research, Technology and Economic Development Park is now open near Mississippi State University's Veterans Memorial Rose Garden. Photo by: Beth Wynn

The Technology Blvd. entrance to the Thad Cochran Research, Technology and Economic Development Park is now open near Mississippi State University’s Veterans Memorial Rose Garden. Photo by: Beth Wynn

STARKVILLE,Mississippi — A new roadway is now open in the state’s largest research park, and its completion sets the stage for expansion, according to Mississippi State University officials.

The new four-lane Technology Blvd. connects with U.S. 182 via Verner Hurt Blvd. just west of the Mississippi Highway Patrol’s Troop G district office, and provides an additional entrance to the Thad Cochran Research, Technology and Economic Development Park near the Veterans Memorial Rose Garden.

“We expect to make significant progress on developing Phase II now that the new road is open and water, sewer and electrical infrastructure are in place,” said Marc McGee, the director of the MSU Research and Technology Corporation, who manages the park.

Columbus-based Burns Dirt Construction, Inc. was the general contractor for the road’s construction, which was funded by the Mississippi Department of Transportation and the National Institute of Standards and Technology.

Since opening in 1989, the park has grown steadily. Its 272 acres are home to 1,500 employees and nine buildings, McGee said.

Park tenants include private businesses, spin-off companies, government offices and research centers and institutes.

“We are very pleased that the new road is open, and believe that it will be an additional catalyst for the momentum we have in Cochran Research Park,” said David Shaw, MSU’s vice president for research and economic development.

“There is nothing else like the park anywhere in Mississippi, and it is a tremendous economic development asset for our state,” he added.

The park is a joint venture between the City of Starkville, Oktibbeha County and MSU, with the university providing day-to-day management.

Source: Mississippi State University


Mississippi Main Street announces 2013 award winners

main streetJACKSON, Mississippi —  The Mississippi Main Street Association (MMSA) celebrated achievements of Mississippi Main Street Communities at the 24th Annual Awards Luncheon in downtown Jackson.

The presentation of awards was made by MMSA Executive Director Bob Wilson and 2013-2014 Board President Joey Hudnall.

“This year’s award winners reflect the commitment of many individuals and groups who champion what Main Street is all about – developing the heart of our communities, our historic downtowns, and enhancing quality of life for everyone,” Wilson said.

Since 1993, MMSA, a program of the Mississippi Development Authority, has generated nearly $4.5 billion in private and public investment (including more than $1 million in public investment). In 2012, Mississippi Main Street communities generated 228 net new businesses, 53 business expansions, 1,248 net new jobs, 111 façade rehabilitations and 160 upper floor housing developments. More than 57,005 volunteer hours were recorded.

MMSA has 51 designated Main Street Communities throughout the state as well as six Downtown Networks and several Association Members.

Established by the National Trust for Historic Preservation in 1980, the National Main Street Center helps communities of all sizes revitalize their older and historic commercial districts. More than 1,800 Main Street programs participate in 50 other states as well as the United Kingdom, Canada and Australia.

Award listing is below:

  Design Best Adaptive Re-use Project Shane Crausby Commercial Real Estate WINNER Pontotoc Shane Crausby
  Design Best Façade Rehabilitation Over $10,000 Kosciusko Strand Theatre Façade Restoration WINNER Kosciusko Mayor Jimmy Cockroft and Ingrid Gonzalez-Featherston
  Design Best Façade Rehabilitation Under $10,000 Onje’s Bakery WINNER Greenwood Marion Howard or Brantley Snipes
  Design Best Historic Rehabilitation Project Woodville Lofts and Studios WINNER Woodville James Derbes and Jan Katz
  Design Best New Signage studio 5 fifty arts center WINNER Laurel Brad Kent and Robby Scruggs
  Design Best Public Improvement Project Breezeway Project (TIE) WINNER Carthage Aaron Akers and Russell Baty
  Design Best Public Improvement Project We Are Laurel (TIE) WINNER Laurel Rex Gilbert and James Hill
  Design Best Public/Private Improvement Project Carrollton/Johnson District Revitalization WINNER Greenwood Marion Howard or Brantley Snipes
  Econ R Best Public-Private Partnership Project Earth’s Bounty WINNER Meridian Maureen Lofton
  Econ R Best Business Retention/Recruitment
Program for Downtown
Main Street Clinton’s New Business Recruitment Packet WINNER Clinton Chris Graham and Nolan Aikens
  Econ R Best New Development Project Rue Vieux LLC WINNER Biloxi Laura Bolton and Rue Vieux members
  Econ R Main Street Merchant of the Year Yvonne Taylor WINNER Batesville Yvonne Taylor
  Organization Best Creative Fundraising Project Club Whispers Panel Auction WINNER Greenwood Brantley Snipes
  Promotion Best Image or Branding Promotion Hooked on Pontotoc WINNER Pontotoc Mayor Jeff Stafford
  Promotion Best Culinary Arts Event Don’t Be Cruel Bar-B-Q Duel WINNER Tupelo Bev Crossen
  Promotion Best Newsletter over 5,000 Canton Connections Weekly Newsletter WINNER Canton Jordan Hillman
  Promotion Best Downtown Directory Tunica Main Street and Highway 61 Corridor Brochure WINNER Tunica Lynn Ryals
  Promotion Best Retail Promotion Sip N’ Cider WINNER Canton Logan Horne
  Promotion Best Special Event Peter Anderson Arts and Crafts Festival (TIE) WINNER Ocean Springs Cynthia Dobbs Sutton and Margaret Miller
  Promotion Best Special Event Bricks and Spokes (TIE) WINNER Vicksburg Kim Hopkins
  Special Special Service Award (Private Sector) Aaron Akers WINNER Carthage Aaron Akers
  Special Special Service Award (Public Official) Mayor Steve Rosenthal (TIE) WINNER Indianola Mayor Steve Rosenthal
  Special Special Service Award (Public Official) Mayor Jimmy Wallace (TIE) WINNER Carthage Mayor Jimmy Wallace
  Special Spirit of Main Street Making a Difference on Main Street Program WINNER Clinton David Winborne and George Ewing
  Special Charles O. Beasley Award Margaret Miller WINNER Ocean Springs Margaret Miller