Worcester Business Journal

wbjournal.com | September 13, 2021 | Worcester Business Journal 35 "ere are lots of limits on both the services that are covered and the types of providers you can go to when you look at the different safety net programs that are available," said Curry, who started her policy work reforming health safety nets before focusing solely on gaining comprehensive care for these at-risk populations. e Children's Medical Security Plan, a safety net offered to uninsured children, covers $200 of prescription drugs and 20 mental health visits per year. "It's also very confusing for anyone, nevermind families who may have language barriers or other barriers to getting culturally competent care," Curry said of the Children's Medical Security Plan. The cost of inequality While these programs go a long way in offering important care, disparities in health outcomes persist among immigrants and people of color. For example, 63% of all dental- related emergency department visits in Massachusetts were from Black or Hispanic/Latinx patients in 2019, according to a report from the Massachusetts Health Policy Commission, demonstrating a disproportionate lack of preventive care access for communities of color, not just for dental health. "ese types of patients are only seen by the system when they are really in need of emergent care," said Sergio Melgar, chief financial officer of UMass Memorial Health in Worcester, the largest provider in the region. "ere has to be something that is terribly wrong." Acute care becomes one of the largest operational burdens for the hospital when it spirals into long- term care, he said. Aer a patient is treated for an acute or emergency health problem, it is extremely difficult to discharge them from the hospital, knowing the other options unavailable to them, said Melgar. Long-term rehabilitation facilities are unlikely to take on the financial burden of treating an uninsured patient without reimbursement, leaving hospitals with more than just monetary responsibility. "Not only are we not getting paid for that, but they're using up capacity and space that may actually restrict another patient from coming in that does need the care," he said. In Worcester, 3.3% of the population does not have health insurance, which is significantly lower than the 9.5% nationally and about the same as the state. Yet even with a lower uninsured population, local hospitals and providers are facing a significant financial burden. Of its roughly $3.2 billion in annual revenue, UMass Memorial Health this year will write off $100 million in charges related to patients that don't have health insurance coverage, said Melgar. As a nonprofit, the hospital offers care to anyone in need, regardless of coverage. It also receives favorable tax reductions based on the amount of discounted care it provides to uninsured individuals. e problem is, many uninsured individuals are unwilling to identify as such, which makes it more challenging for the hospital to mark an unpaid bill as charitable. is is especially prevalent among undocumented immigrants, who might be afraid to identify themselves and their status, said John Salzberg, chief revenue officer at UMass Memorial. In these cases, the hospital goes aer the patient, and the cost is typically written off as bad debt, which cuts into 1-2% of UMass Memorial's revenue, according to Melgar. A way forward Curry and her team at HCFA have been working since 2017 to prioritize undocumented children in the fight for equitable healthcare coverage for all kids. e organization filed a broader healthcare bill for undocumented kids last legislative session, which made it to the Ways and Means Committee in the state Senate. is session, its bill focuses on gaining insurance for children with disabilities, regardless of immigration status, with hopes of getting the highest-needs children covered as a first priority. Curry said health disparities revealed by the pandemic have amplified the need for equitable healthcare for immigrants. "It may be a matter of priority," she said. e most recent HCFA bill demanding health care for all disabled children regardless of status is currently in the Senate's Joint Committee on Healthcare Financing. Working Together for a Greater Good. Make a difference by joining our Diversity, Inclusion and Equity Commi ee, becoming a mentor in the Mentor Connec on or volunteering. info@bgcworcester.org The beauty of the world lies in the diversity of its people www.bgcworcester.org F O C U S Sergio Melgar, CFO of UMass Memorial Health in Worcester Employees don't have to get vaccinated Worcester County, along with most counties in Massachusetts, is experiencing a substantial community transmission of coronavirus, according to the U.S. Center for Disease Control. In order to combat a further spread of the disease, organizations like UMass Memorial Health, the largest employer in Central Mass., are requiring their employees to receive the COVID vaccine, as is the federal government, along with several Massachusetts state agencies. When polled online, the majority of WBJ readers said they won't require vaccines for employees. F L AS H P O L L Is your company requiring or planning to require employees to get the COVID vaccine? No, that remains a personal medical decision. 54% No, but non- vaccinated employees are subject to regular testing and/or other restrictions. 20% "I will never require my staff to subject themselves to something that has no history. We will see what happens in years to come what the fallout of this vaccine will be. I truly hope for the best. Here at my multiple business sites we will let our people make their own decisions as adults." Yes, we already do. 16% Yes, we plan to require the vaccine soon. 9% COMMENTS: W

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