Editorial counterpoint: Health care ailment spreads far beyond hospitals

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It certainly may be the case that Minnesota's acute care system is feeling some minor financial pain undoubtedly caused by the ongoing effects of the pandemic, which decimated disability and other long-term care organizations over the past three years ("Vital signs poor at Minnesota hospitals," editorial, March 5).

In turn, combined with the workforce shortage catastrophe across the entire health care continuum, this accounts for just over half of negative operating margins the state's hospitals and health systems are reporting for 2022 (according to the Minnesota Hospital Association).

But for those of us in the post-acute space of the health care continuum, this has been the unfortunate reality for many organizations for many, many years. This is especially true for entities that primarily or exclusively serve low-income individuals with disabilities and/or seniors on Medicaid and have zero control over the rates we are reimbursed for the complex, critical and person-centered care we provide 24/7/365 to patients wherever they call home.

We have been stuck for quite some time in the kind of nightmare where you attempt to scream for help but no sound escapes your mouth (or least no one hears it). Interestingly, though, it wasn't until the financial bottom lines of our acute care "partners" dipped slightly into the red that the general public, legislators and others started to take notice.

The Star Tribune Editorial Board "strongly recommends a targeted, temporary $50 million state grant program to offset hospital costs from delayed discharges." The question is: Why? What will this solve, short- or long-term?

The hospitals and health systems this grant program purportedly aims to prop up are the same organizations and businesses that have consistently reported growing profit margins year after year, that receive state and federal reimbursement for the far-too-often reactive model of costly "sick care," and have been causing havoc among the post-acute workforce for years by poaching staff, including nurses, by offering wages higher than those of us who depend exclusively on the Legislature's set reimbursement rates can compete with.

Fortunately, this session several legislators and state agency staff actually seem interested in solving the downstream issues that caused a reported 14,000-plus unbillable hospital days in one week in Minnesota hospitals due to individuals not having a safe place to discharge to — or the 11,000 denials to folks who were unsuccessfully trying to move into an assisted living/skilled nursing facility in one month this past fall due to the extreme workforce shortage.

It certainly is not, in my opinion, the troubles of the "heads in beds" antiquated sick-care system, or the single-digit negative operating margins of some of the largest businesses in our state that are the most alarming problems in our health care continuum. Distracted by the hospitals' reimbursement and financial challenges, the Editorial Board hinted at what the real issue just might be: the strained and at-capacity post-acute organizations like disability service providers, home care agencies, assisted livings, etc.

These entities have been collapsing for years or barely holding on. Now more than ever I hope some real and meaningful action is taken before we all witness the complete unraveling of the health care continuum in Minnesota.

Josh Berg is a member of the City Council of Elko New Market, Minn., director of Minnesota services at Accessible Space, Inc., a supportive housing nonprofit based in St. Paul and previously director of growth at Lifespark senior care services.