Hospital sale proposed?

Ex-Jindal health chief denies he urged LSU action

A former Jindal administration health chief was quoted in an LSU document released late Thursday as recommending LSU sell its hospitals in Shreveport, Houma and Bogalusa to help generate state dollars to fund Medicaid.

But Alan Levine, now an executive with Health Management Associates Inc., said in a Thursday interview that he was misunderstood.

Rather than selling, Levine said he recommended to LSU officials that the hospitals be leased to private entities as a way to increase revenue. He said the arrangement would also lead to improvements at the hospitals as the private firm puts up money to keep them updated.

“I don’t think you would want to sell them. They are important assets,” Levine said.

Levine met July 17 with top state health care and LSU officials, including members of the LSU System’s Board of Supervisors.

“The sale versus lease and cooperative endeavors, all of those were discussed in a spectrum of things that could be considered,” LSU System Vice President Fred Cerise said Thursday. Cerise said LSU favored models under which it would retain more of a partnership with a private entity.

The undated memo was written to LSU System President William Jenkins by Cerise, who oversees health affairs and medical education. It was acquired with a public records request.

The meeting with Levine occurred as LSU struggled with how to absorb some $320 million in Medicaid budget cuts in its 10 hospital system.

The cuts were imposed by Gov. Bobby Jindal after a sudden loss of federal funding support. The LSU Board on July 27 approved a plan of reductions and implement reductions in medical programs and services throughout the system to cover much of the lost revenues.

With the immediate financial crisis addressed, Cerise said the LSU Board is looking at a variety of public-private partnership options for the future.

Levine’s firm Health Management Associates Inc., based in Naples, Fla., has been active in partnerships with schools of medicine in Florida and Mississippi. He resigned as state Department of Health and Hospitals chief about two years ago.

Levine said he was invited by some LSU board members to give advice and was not representing his company.

According to the LSU memo summarizing the meeting: “He (Levine) stated that the purchase of an LSU hospital would generate revenue that the state could use to match in the Medicaid program. He recommended as an initial step that LSU sell its hospital in Shreveport and use the proceeds to offset the budget cuts for the rest of the LSU system.”

Shreveport is the home of one of LSU’s medical schools.

The memo stated that Levine suggested that the hospital buyers would form a joint venture with LSU, invest capital into the facility and develop a strategy for LSU “to more aggressively compete in the hospital market.”

According to the memo, Levine also stated that he believes there would be opportunities with a capital partner to purchase additional hospitals such as East and West Jefferson or Terrebonne General and manage them in a joint venture with LSU.

“The LSU board members present indicated they want LSU’s management to pursue this strategy,” Cerise said.

The LSU board members present were Rolfe McCollister, Bobby Yarborough, both of Baton Rouge; John George, of Shreveport; and Scott Ballard, of Covington.

According to the memo, Cerise indicated that he was concerned that the strategy that Levine suggested would “take a lot of time to develop and that LSU would likely need to go through a competitive public procurement process and likely legislative approvals.”

In a subsequent memo to Jenkins, Cerise wrote he was concerned about the proposed Shreveport hospital sale during the current state budget year that began July 1.

“There is no commitment by DHH to mitigate the budget reduction while we work on the very complex Shreveport deal,” Cerise wrote. “Therefore, if later in the year, we realize that we cannot close a Shreveport sale by year end, we will run a deficit, which is against the law, and grounds for removal of those causing the deficit.”

Cerise also predicts “a significant negative community reaction” on several fronts, including using hospital sale proceeds on LSU hospitals in south Louisiana.

On Thursday, state Sen. Sherri Smith Buffington, R-Keithville, said she had heard rumors of discussions about a Shreveport hospital sale.

“Certainly the Health Sciences Center in Shreveport is such an important part of the northwest economy I certainly feel strongly these discussions should certainly be taking place with the community leadership here,” said Buffington, who is vice chairwoman of the Senate Health Committee.

The meeting also featured a discussion of cost-saving measure the board had requested from LSU executive hospital executives to make up for the Medicaid funding hole. Five scenarios were discussed.

One scenario, according to the memo, would have redistributed DHH cuts and bridge LSU to 2014 “at which time the Medicaid expansion would provide significant financial relief as a way to sustain services and training programs.”

The Medicaid expansion is a part of the Obama administration’s national health care revamp and would cover people with incomes up to 133 percent of the federal poverty level. The memo stated that the proposal was “immediately rejected” by DHH Secretary Bruce Greenstein. Greenstein agreed to work with a consulting group on “possible sources of additional federal funding,” Cerise’s memo to Jenkins stated.


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Comments (9)


1) Comment by JWT - 03/08/2012

@NewsReader - only one of the issues per your remarks - several things need to happen such as revisiting the state's constitution via where cut are happening to balance the budget. Our STATE's law allows parents to carry their children on insurance until age 26 so now I ask you to google "percentage of children born on Medicaid in Louisiana and look at the article by Louisiana Medical News" Per a quote " The impact of Medicaid cuts is disproportionately large for Woman's Hospital because we are the largest provider of obstetrical and neonatal services in the state," CEO Teri Fontenot said. "More than 70 percent of the babies born in Louisiana are covered by Medicaid; therefore, each time DHH makes an across-the-board cut, the financial impact to Woman's is greater."

2) Comment by NewsReader - 03/08/2012

JWT, to answer your last question. Nope probably not the smartest idea to put people into a broken system. But by the same token we cannot ignore the plight of the uninsured. Neither side has the answer. You should not mandate coverage when people can't afford it as it is, then penalize them for not being able to afford it because there are no clear paths to cutting the cost. And then the opposing party doesn't want to raise taxes to pay for services that are needed. Meanwhile everyone is stuck in the middle. But you did hit the nail on the head in your paragraph: state revenue hasn't grown. And why is that? Corporate revenue has. We've just had political leaders who for the past decade have decided to give away the revenue portion to make them appear like they are doing some good for the state by attracting business.

3) Comment by IMVOR - 03/08/2012

You people are weird.

4) Comment by JWT - 03/08/2012

This is no magic solution for the uninsured, especially since Medicaid is in need of REFORM, not expansion. States’ share of the cost of Medicaid is already crushing state budgets. In the past decade, Medicaid spending has increased at nearly twice the rate of states’ tax revenue. The only ways to expand Medicaid are to raise taxes, cut other state programs, or slash health care providers’ reimbursements in Medicaid even more. The majority of America’s governors have said they won’t do it. Should we be putting more people into a broken system that doesn’t work ??

5) Comment by NewsReader - 03/08/2012

Attila, but you're missing something. You really think that just by BJ not taking those funds that the none of those 40K people mentioned by nolalawyer will get sick? Who will pay for their uninsured treatment they WILL go seek? So what's better, paying a percentage of the cost because the Feds are chipping something in, or stick the hospital with 100% of the cost which will then get passed onto other insureds? Either way you're paying for it. Getting the Fed dollars would have just made you and me pay a little less for a few years. But like Pakistani said, the only thing BJ is interested in is short term balancing of the budget with one-time funds. When he's gone he won't care no more.

6) Comment by Pakistani - 03/08/2012

Sell something so Pakistani boy can use one time money to fill his budget deficits and not have to raise taxes. Great short term plan for Pakistani boy.

7) Comment by Attila - 03/08/2012

Thank goodness you are not a lawyer as we have enough incompetency in that profession already. What fairy tale land do you live in? Do you actually believe that adding half a million people to the Medicaid rolls will cost the taxpayers of this state NOTHING? While I have lost a lot of faith in BJ I think the decision to refuse government Medicaid funds is a good one. It is the same old ***** The feds dangle a carrot by saying they will pay the entire bill for three years. What happens in the fourth and subsequent years? It starts as the state picking up 10% of the costs. Who knows where it ends.It is obvious that even at the 10% funding level that Louisiana will become responsible for, at a minimum, tens of millions of dollars in Medicaid costs to extend coverage. Where are we to get the money to pay the bill? Wait! It is coming to me now....we can raise taxes on the producers just like we always do...not a good solution.`

8) Comment by lovemykids - 03/08/2012

Thanks nolalawyer!

9) Comment by nolalawyer - 03/08/2012

From the documents mentioned in the article, we now have solid confirmation that Jindal is willing to hurt all of us to advance his personal political goals -- by rejecting the additional Medicaid coverage provided by the Affordable Care Act ("Obamacare") so that he can pick up an extra mention by Sean Hannity every now and then. See the last paragraph in the article -- the option of just accepting the additional federal funds and allowing thousands of uninsured Louisiana citizens to become eligible for Medicaid was "immediately rejected" by DHH Secretary Greenstein. The working poor who aren't eligible for Medicaid today but who would be eligible under the new law are hurt -- they won't have health insurance thanks to Jindal's selfish decision. Those of us who aren't poor, and indeed the entire state, are hurt by Jindal's action because the whole system is dragged down as we now see happening -- the LSU health system is being destroyed, and important rural hospitals like Lallie Kemp may have to close their doors, all so little Bobby Jindal can show the adult Republican establishment that he's all grown up. Secretary Greenstein -- I know you have to do precisely what Jindal tells you to do, but at some point don't your personal values kick in and make you call a halt to these horrible policy decisions, because you know that they're being made only for Jindal's self-promotion? It has to be tough for you -- I can only imagine the scene when you get home from work: "Hi, Honey -- how was your day?" "Well, let's see -- today I deprived 40,000 of my fellow citizens of health insurance, which wouldn't have cost the state a dime." I can't recall any other situation in recent Louisiana history where one politician's hopes for personal advancement caused so much harm to so many people. Governor Jindal -- sir, have you no shame at all? You're only stopping by the state occasionally, to get a clean change of clothes for your next trip for Romney; is it too much to ask that you not keep thousands of us from getting health insurance while you're here? Aren't you just a little bit worried that your political ambitions are leading you to forget the oath you took to serve our state instead of yourself?