Hospital determined to maintain affordable care though prices soar

Despite the challenges of rising health-care costs and low Medicare reimbursements, Carson Tahoe Regional Medical Center will strive to deliver good health care at a reasonable price, hospital Chief Executive Officer and President Ed Epperson said Wednesday.

And that price steadily increases while the number of the insured shrinks. About 45 million Americans, or 15.6 percent of the population, were without health insurance coverage in 2003, according to the National Coalition on Health Care.

Many of these Americans rely on federal help in the form of Medicare or Medicaid. Epperson said this is a particular challenge for the medical center because it receives about 50 percent of its payments from Medicare. It's the hospital's No. 1 source of payment.

The federal assistance program is generally available for people 65 or older, younger people with disabilities and people with end-stage renal disease.

And it's not paying out what it used to. Medicare reimbursements are not matching what the patients spend on health care.

"We're getting paid significantly less than our costs," he told about 120 business leaders at the Northern Nevada Development Authority breakfast meeting at the medical center. "The game is - and has been for years - to shift the costs that aren't getting paid for to the private sector, such as insurance companies."

Floyd Rowley, a vice president with Colliers International, said after the meeting that health-care savings accounts could ease this situation.

"It seems to be a very free-market way to decouple the employer bond from health insurance," he said. "It's good for the employee because they can switch jobs when they need to and keep their insurance and it's good for the employer because they can save the costs."

The hospital CEO said the health-care savings accounts will become more important.

He placed the blame of escalating medical costs on several factors, one of which is the high profits made by insurance companies and the multimillion dollar pay outs they give to their executives.

He said the aging population's demand for health care - in general, people require more health care at the end of their lives - is another reason for the sector's ballooning, making it the sixth largest economy in the world. In Nevada, the health-care costs per patient per day staying in the hospital is $1,943.

Epperson also cited the cost of advancing technology. For example, cardiac stents coated in a special drug cost $3,200 each. The older version of the stent, which are metal objects resembling scaffolding that open up the arteries, cost $1,000. With more than a million angioplasties performed in the United States just in 2002, that cost increase is substantial, Epperson said.

"That added $2 billion to costs of health care, and I can tell you hospitals are doing a lot more angioplasties this year than in 2002," he said.

Costs associated with the hospital aren't low either. Carson City's medical center pays out $55 million in salary a year for its 1,300 staff members, which includes more than 275 physicians, the chief executive officer said. The average Nevada physician makes about $283,000 a year.

-- Contact reporter Becky Bosshart at bbosshart@nevadaappeal.com or 881-1212.