‘Unfair to compare CHCC to Guam’

Commonwealth Healthcare Corp. CEO Esther Muña said it’s unfair for the Legislature to keep comparing the Commonwealth Health Center to the Guam Memorial Hospital in terms of its fees and rates.

Unlike the Guam Memorial Hospital Authority, which runs the hospital in Guam, CHCC was only appropriated a measly $708,311 for fiscal year 2018. In contrast, the Guam Memorial Hospital Authority gets $40 million every year from the U.S. territorial government, according to her.

Muña made these comments after a joint committee meeting of both the House of Representatives and Senate health and welfare committees Wednesday on Capital Hill, wherein some members of the Legislature kept comparing CHCC’s situation with Guam.

“We have no leverage compared to Guam. They keep comparing us to Guam but, when you use that as basis, that would be unfair to this community. Guam gets appropriation, has a funded medical indigent program, and Guam has more Medicaid funding than we do. There are a lot of differences,” she said.

“Guam has basically about $40 million of appropriation from the government itself. That is not even questionable. Last year alone, we have $13 million of uncompensated care cost based on our bills,” added Muña.

Uncompensated care is healthcare given to people who cannot afford to pay.

Muña also went on to defend CHCC’s planned increase in rates vis-à-vis the paltry $708,311 budget the Legislature appropriated it for fiscal year 2018.

“When we didn’t get the appropriation that we asked for, we had two ways to generate our own funds. It was either to take the market base rate or take the cost-to-charges ratio.”

“Using the market base rate was ideal as this is the rate that even Medicaid and Medicare use as part of their payments. However, when it came to this particular situation, where we have a huge amount of uncompensated care, we decided that cost-to-charges ratio would be more effective rather than the market base rate because the economy is doing great but is that reflective of the services here at CHCC? Obviously not,” she added.

Muña said that when they calculated cost-to-charge ratio and thinking that they needed to get back they lost, adding $2,266 on top of the current room rates was inevitable.

“An ICU room cost could’ve been over $4,000 if $2,266 was applied but we became conservative by making it $4,000 flat and we rounded off in certain areas,” she said.

“We didn’t add $2,266 in every single room. We did increase based on that but we decided not to go over it. We have that rate base and we could’ve gone over that rate but we chose to be conservative and never went over,” Muña added.

Another discussion that was brought up during the joint session was for CHCC to consider privatization.

“One member of the Legislature mentioned ‘privatization.’ When you talk about privatization, you talk about private businesses coming into partnership with CHCC. But the reality is that one of the questions that these private entities will ask is, ‘Who is going to pay for the people that cannot pay? We need to make a profit too,’” she said.

Muña said there have been some proposals in the past about privatization, but added that what is being talked about here is basic services, which is healthcare.

“Why is that a priority for you to give someone the opportunity to profit when this is your business? This belongs to the people. You cannot expect the private business to take care of the indigent population,” she said.

Muña said if the CNMI government will give CHCC the money to avoid this gap, the proposed increase in room rates can be delayed or be put it off.

“We are not making a profit here. We are just making services available for everybody. The cost that we came up with was not arbitrarily done. It was done by looking at the uncompensated cost because that’s the one that is hitting us the most,” she said.

“We know what the people want.We are willing to do it but how are we going to do it if we are left without the money?” Muña asked.

She reiterated that the hospital is still willing to hear what the community has to say about the rate increases.

“People still have an opportunity to give their comments on the rates. I’ve seen people complain about the rates but it hasn’t even affected them. We want to know how it has affected you or how do you think it will affect you. Right now, CHCC remains and will always be available to the people,” said Muña.