A Silver Lining
"We have an outreach team of navigators who are doing calls and making visits to patients. We have patient education materials, banners, direct mailings, information on our website, employee trainings," Burnette says. "One of the things we do is inform patients about co-pays so they can be prepared. But, of course, we don't turn away a Medicaid eligible patient for lack of a co-pay."
Amid all the uncertainty and potential fiscal landmines safety net hospitals have to brace for with regard to HIX and Medicaid expansion, Burnette says there is one silver lining: CMS's decision in late December to delay cuts to its disproportionate share funding.
"Originally cuts were going to start on Oct. 1, 2013, before we even knew how many people were going to enroll in the exchanges," she says. "With the delay, we are really going to have some time to assess… It's definitely too soon to know what the impact will be, and that has always been the big question. The delay will give us time to have actual data, and we will look at it quarterly so we can see what is happening with our uninsured population, how many are going into Medicaid, how many are going to have insurance."
While the delay in DSH cuts allows more time to collect the data needed to move forward successfully in the new era of healthcare, Burnette says the changes coming out of the Patient Protection and Affordable Care Act are Denver Health's toughest challenge right now.
"I think health reform is our biggest challenge because although it represents a great opportunity, we have to stay on top of it because it is very complex, and we have to minimize the bad debt that comes out of it," she says.