Is the Med Going to Survive?

The financing of the Med is a critical item and has been much in the news lately. County Commissioner Mike Ritz has been deeply involved in this issue and in trying to get the Med’s fair share of Federal money that has been diverted by the state government. It is a complicated issue and it also involves the Methodist and the Baptist systems. Are they behind the push to get more of the Med’s money from the state? How much and at what percentage are they compensated for uncompensated care? It would seem that they would have much to lose if the Med ceased to exist and all the Med’s patients showed up on their door step.

Here is Commissioner Ritz’s email to various local officials.

Subject: The MED’s current financial situation with the State of Tennessee


                Thank you for meeting with us on Mayor Ford’s task force and the subcommittee of the local hospital CEO’s, Mayor Ford, Chairman Collins and myself. You asked that I share with you some of the MED financial worksheets to best  present and represent the MED’s financial relationship with the state of Tennessee. The attached worksheets explain how the State of Tennessee holds the financial future of the MED in its hands.

The Recent Federal Payments worksheet shows ( Line A) that since FY 2005 the state has received between $61,186, 225 to $91,828,402 annually from the Federal government based on the MED’s uncompensated care BUT , per Line 5, has only returned $18,896,518 to $38,596,759 of those annual payments to the MED. If the state wants to count their GME payments (Line 6), 2% cigarette tax payments (Line 7) and two old special purpose grant programs (Lines 8&9), then all the state payments still only total $23,961,771 to $44,784,610 annually to the MED.

The worksheet comparing the MED to the other state teaching and public hospitals shows that only three public hospitals in Tennessee have uncompensated care for which the federal government sends reimbursements to Tennessee. Those 3 hospitals are the MED, Erlanger and Metro. Those 3 hospitals had uncompensated care over $161 million recently reimbursed to the state. However those 3 hospitals only received $58 million back from the state for this care. The state used over $100 million of the federal reimbursements for other state health care expenses. For the MED that year over $84 million was collected by the state on the MED’s unpaid billings but the MED only received  $34.4 million. The state that year kept $49.7 million of federally reimbursed MED billings for other state uses.

It is not fair or equitable for the MED to be in its current financial condition or for Shelby County Government taxpayers to have to pay more than they currently pay ($27,000,000.00 annually).

We understand that  federal law and Tenncare rules provide/allow the Governor to exercise discretion for its use and allocation of these public hospital uncompensated care reimbursements from the federal government, however the current situation is not fair or equitable to Memphis and Shelby taxpayers, citizens or voters.

PS: How can we legitimately ask the States of Mississippi and Arkansas to reimburse us for their uncompensated care when our own state treats the MED this way? 

 I would appreciate your comments on this situation.  As usual, I believe in transparency and I would like to see the total financial statements of the Med, Erlanger Chattanooga) and Metro Nashville. I cannot find any of these online including our own Med.




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