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State seeks new system for paying for treatment



Published: Mon, August 1, 2005 @ 12:00 a.m.



The current system allows payment to hospitals based on the bills they submit.

COLUMBUS (AP) -- Business, labor and health care providers will work with the Ohio Bureau of Workers' Compensation to reform a payment system that has apparently reimbursed nonprofit hospitals far more than the actual cost of treating injured workers.

The bureau will hold a symposium Tuesday in Columbus to gather input from the various groups.

"The OHA is going into the meeting with an open mind and a flak jacket," said Tiffany Himmelreich, spokeswoman for the Ohio Hospitals Association that defends the payments.

The Service Employees International Union District 1199 will present a proposal that union officials say would save $90 million a year. The union earlier this month released an analysis showing that workers' compensation claims represent 1 percent of hospitals' caseloads but 12.5 percent of the money they make.

The union represents 27,000 health care workers in Ohio, Kentucky and West Virginia.

Under the union's plan, the bureau would reimburse hospitals for the cost of care -- as defined by the federal government -- plus 10 percent. The current system allows payment to hospitals based on the bills they submit, which sometimes are much more than the actual cost of care.

"No one looking out for the interest of workers, the public or consumers in general would design a system like the one we have," said union President Dave Regan.

Hospital officials argue that their costs are greater than the federal calculation and their markups are lower than what the union says. The hospitals have not provided specific figures for their costs or the payments to them.

The bureau intends to let all of the groups have input in determining what changes should be made in the payment system, but the state will take an active role in devising the new system in contrast to the last negotiations in the mid-1990s.

"This time we are going to take the lead on the issue of hospital fees," said bureau spokesman Jeremy Jackson, adding that the current system is not the solution.

Bureau officials hope to devise a payment system that reduces hospital costs without jeopardizing benefits to injured workers, Jackson said.




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