Valley View’s indigent care subsidies drop

Post Independent–Valley View Hospital absorbed fewer indigent care expenses last year than it did in 2013, while the rolls of patients covered by Medicaid increased under newly expanded federal health-care provisions.

According to the Glenwood Springs-based hospital’s 2014 annual report, Valley View provided $9.8 million worth of “charity care,” or uncompensated patient care costs, compared to $16.4 million in 2013.

The decrease was primarily due to expanded Medicaid that went into effect last year in Colorado under the federal Patient Protection and Affordable Care Act, or “Obamacare,” President Obama’s signature health-care reform law.

“We did see that number drop with the Affordable Care Act … but our Medicaid numbers went up also,” Valley View CEO Gary Brewer said during the hospital association’s recent annual meeting.

Valley View, which operates as a nonprofit organization, recorded a 4.2 percentage point increase in Medicaid patients served last year, from 13.3 percent of total patients in 2013 to 17.5 percent last year, said Stacey Gavrell, community relations director for VVH.

That number has risen steadily since 2010, when Medicaid recipients accounted for about 10.1 percent of Valley View patients, Gavrell said.

Likewise, Grand River Health District in Rifle saw a similar decrease in charity care provided over the past two years, along with a corresponding increase in Medicaid numbers.

Between Grand River’s hospital and clinical services, the amount of charity care decreased to about $3.9 million last year, down from $5.4 million in 2013, according to Annick Pruett, community relations director for Grand River Health.

Medicaid revenue, on the other hand, increased from $13 million in 2013 to nearly $22.4 million last year.

Grand River did not have a breakdown of Medicaid patients served for those two years, but the dollar amounts represented 24.8 percent of total revenue in 2014, and 18 percent of the total in 2013, according to Ed Johlman, chief financial officer for the tax-supported district.

The U.S. Department of Health and Human Services reported last week that, as a result of new marketplace coverage and Medicaid expansion, uncompensated hospital care costs were reduced by an estimated $7.4 billion in 2014.

“Medicaid expansion states account for an estimated $5 billion of that reduction,” according to an HHS news release corresponding with the five-year anniversary of the ACA.

Colorado was among the states to offer expanded Medicaid for those who qualified based on income during the first year that health insurance came under the new federal and state insurance exchange systems.

Garfield County saw a huge surge in the number of people signed up for Medicaid. According to the Colorado Health Institute, Garfield County had a monthly average of 11,458 people enrolled in Medicaid during 2014, compared to 7,968 in 2013.

That number had risen yet again to 12,973 enrollees as of January this year, according to statistics available on the Colorado Health Institute website [].

Neighboring Pitkin County has also seen a drastic increase in the number of Medicaid enrollees, from just 438 in 2013 to 1,126 last year. That number was up to 1,443 as of January, just prior to the final federal health insurance enrollment deadline of Feb. 15.

The amount of charity care provided by Valley View had risen drastically in the years following the Great Recession that began in late 2007.

In 2006, the hospital provided $3.6 million in charity. That figure increased to $5.3 million in 2007 and $6.7 million in 2008 before nearly doubling to $12.7 million in 2009 and peaking at $16.5 million in 2011.

While some of that increase could be attributed to the overall economy, it also came as Valley View began to offer more specialized, and thus more expensive, services, Gavrell noted.


Meanwhile, Valley View Hospital as an institution continues to grow and expand, according to other statistics contained in the hospital’s annual report given at the March 12 annual meeting of the 81-member Valley View Hospital Association

The number of physicians on staff increased in 2014 to 212, up from 198 the previous year. And, the number of full-time equivalent employees has also increased from 708 to 748, partly due to the acquisition of the former Roaring Fork Family Physicians practice and construction of the new medical clinic in Carbondale, Gavrell said.

Total salaries and benefits for hospital staff also grew last year to $89.9 million, from $84.8 million the previous year.

This year, Valley View is prepared to move some of its operations and services into the now-vacant fourth floor of the Calaway Young Cancer Center addition. Expected to occupy that space by this fall will be the Glenwood Orthopaedic Center, the Lung Center and Valley View’s new plastic surgeon, Dr. Jennifer Butterfield, according to Gavrell.

The hospital cafeteria is also slated to be relocated to the fourth floor space in early 2016, she said, enabling the current third-floor cafeteria space to be used for patient care.

Providing adequate parking for patients, visitors and employees continues to be a concern for Valley View, as the east lot is often at capacity during the day.

“We are still analyzing and looking at options so we can make sure to best serve our patients and visitors,” Gavrell said.

One off-site employee parking lot has already been established on 19th Street, west of the hospital. Valley View has considered building a multi-level parking deck in the future to keep up with the growing demand.