After several years of hard work to get Mineral Community Hospital’s budget back on track it is once again faced with financial challenges with state budget cuts and Blue Cross Blue Shield pulling out of the Medicare Advantage program.

As Montana Legislators go into special session this week to try and cut $227 million from the state’s ailing budget, rural hospitals are facing a three percent cut in Medicaid funding. If the budget can’t be balanced with the governor’s proposals there will be no choice but to cut more costs including healthcare said Mineral Community Hospital CEO, Ron Gleason.

The three percent cut to Medicaid is not a gigantic amount of money, “but we are just coming out of a very difficult time and whenever we have payment cuts coming in our direction it makes it more difficult to continue to take steps back from that edge we were on a couple of years ago,” he said.

The hospital has already cut its staff from 75 full time employees to just 60 and Gleason said there isn’t much more they can cut from their operations and still remain in good standing with the rules and regulations the emergency hospital must adhere to.

“If you combine those budget cuts with increasing drug and supply costs plus pay raises, we will have no choice but to increase our prices,” he said.

The hospital actually saw a small profit this year with July, August and September being their busy months. Things slow down during the winter and they have to rely on their reserves to get through the rest of the year.

“It’s one step forward and two steps back,” he said of the continuing fluctuation in the healthcare industry.

Another pressing issue facing the hospital is Blue Cross Blue Shields recent announcement that they will no longer offer Medicare Advantage in 2018. The dropped policy affects nearly 7,500 residents in 30 Montana counties including Mineral. However, they will still be offering the Medicare Supplement Plan.

Medicare Advantage will still be offered in nine of the state’s more urban counties but leaves the rest of its members scrambling to find a replacement policy. Humana is the only other insurance company who offers a Medicare Advantage plan in Mineral County and has been advertising their policies locally. However, Gleason said they do not have a contract with Humana.

Monida is the regional group who represents the Mineral Community Hospital and they are actively working on getting a contract worked out with Humana. However, Blue Cross made their announcement on Oct. 1 which leaves little time to get a contract into place before the dropped policies go into effect on January 1, 2018.

“It usually takes three to six months to work out a policy agreement,” said Gleason. If a resident does get a Humana Medicare Advantage Plan they can still use the Mineral Community Hospital emergency facilities, but they would be considered an “out-patient” since they don’t have the contract to be considered a part of the insurance network of providers.

What Medicare Advantage Plans provide is all Medicare Part A (hospital insurance) and Medicare Part B (medical insurance) coverage. A Medicare supplement insurance policy, also known as Medigap, are sold by private companies. They can help pay some of the health care costs original Medicare doesn’t cover, such as copayments, coinsurance, and deductibles. A Medigap policy is different from Medicare Advantage in that it only supplements original Medicare benefits. There are advantages and disadvantages to each type of policy depending on individual medical needs.