♪ ♪ >> CATHY: HENNEPIN COUNTY MEDICAL CENTER IS MINNESOTA'S BUSIEST LEVEL ONE ADULT AND PEDIATRIC TRAUMA CENTER.

ONE OF THE STATE'S "SAFETY NET" HOSPITALS.

A TRAINING GROUND FOR MEDICAL PROFESSIONALS.

HCMC IS ALSO FACING A FINANCIAL CRISIS THAT HAS ITS FUTURE IN DOUBT.

CAN A CLOSURE BE STAVED OFF BY HELP FROM THE LEGISLATURE?

ONE OF MANY QUESITONS FOR OUR NEXT THREE GUESTS.

HENNEPIN COUNTY COMMISSIONER JEFFREY LUNDE CHAIRS THE HENNEPIN HEALTH BOARD, THE GOVERNING AGENCY FOR THE HOSPITAL.

DR.

RAHUL KORANNE HEADS UP THE MINNESOTA HOSPITAL ASSOCIATION.

AND DR.

LISA MATTSON IS HEAD OF THE MINNESOTA MEDICAL ASSOCIATION.

IT'S A REAL PLEASURE TO HAVE EVERYONE HERE.

THANK YOU SO MUCH.

COMMISSIONER, PEOPLE WANT TO KNOW WHY THE STRUGGLE.

AND FOR FOLKS WHO MIGHT NOT KNOW, HCMC TAKES EVERYONE, RIGHT?

>> YEAH.

>> Cathy: YOU HAVE TO TAKE EVERYONE.

BUT SO MANY PATIENTS THAT YOU SEE ARE POOR.

THEY CAN'T PAY.

AND MEDICARE, MEDICAID DON'T PAY ENOUGH.

IS THAT JUST KIND OF THE ISSUE IN A NUTSHELL?

>> IT IS.

AND I THINK AS WE LEFT THE PUBLIC HEALTH EMERGENCY FROM COVID, YOU TARTED TO SEE A LAGGING TAIL, AND AS PEOPLE START TO MOVE FROM COVERED TO MEDICAID EXAMINE THEN PEOPLE ARE FALLING INTO SELF-PAY, YOU'VE REALLY SEEN OUR CLIENTELE, OUR PATIENTS CHANGE.

ABOUT 80% OF OUR PATIENTS ARE MEDICAID/MEDICARE AND SELF-PAY.

AND THAT MEANS THAT THEY COME WITH, YOU KNOW, CHALLENGES FINANCIALLY.

>> Eric: PART OF THE STORY IS THAT 25% OF THE CLIENTELE, THE PATIENTS, ARE FROM ANOTHER COUNTY OTHER THAN HENNEPIN.

>> YUP.

>> Eric: AND WONDER, CAN'T THE OTHER COUNTIES THAT BENEFIT FROM THIS BE PREVAILED ON TO COME ACROSS WITH SOME MONEY?

>> WELL, I THINK THAT'S ONE OF OUR PLANS ON THE REPURPOSING THE BALLPARK SALES TAX IS TO CAPTURE THAT.

WE KNOW WE CAN GET ABOUT 25% OF THAT SALES TAX WILL COME FROM OUTSIDE HENNEPIN.

SO AT LEAST HERE WILL BE SOME RECOUPING OF THE MONEY.

BECAUSE RIGHT NOW, THE HENNEPIN COUNTY PROPERTY TAX OWNERS ARE PAYING FOR HEALTHCARE FOR MANY PEOPLE.

AND I THINK WE'VE KIND OF HIT THAT LIMIT.

>> Cathy: LET'S TALK A LITTLE BIT ABOUT OTHER HOSPITALS.

YOU KIND OF ALLUDED TO THIS, ERIC, AND I WONDER IF A PATIENT, SAY, IS N DULUTH AT A ESSENTIA AND THEY NEED TO COME DOWN TO THE TWIN CITIES AND MAYBE GO TO CMC'S BURN UNIT, WOULD A HOSPITAL SYSTEM LIKE ESSENTIA PAY HCMC OR NOT?

>> SO, YOU KNOW, THIS IS WHAT'S SO COMPLICATED ABOUT HEALTHCARE.

INSURANCE COMPANIES PAY, THESE ARE THE HEALTH INSURANCE COMPANIES, AND TO COMMISSIONER LUNDE'S POINT, YOU KNOW, WHEN MEDICAID AND MEDICARE DO NOT PAY UP TO THE COST OF CARE, AND MEDICAID RIGHT NOW, THIS IS A STATE AND FEDERAL PROGRAM, IT'S ONLY PAYING 68 CENTS ON THE DOLLAR OF COST, MEDICARE IS PAYING 80 CENTS ON THE DOLLAR OF COST, HCMC HAS 75% OF THEIR PATIENTS ON THESE GOVERNMENTAL PROGRAMS, SOME OF OUR RURAL HOSPITALS HAVE 75, 80% OF THEIR PATIENTS IN RURAL COMMUNITIES THAT ARE ON THESE PROGRAMS, WELL, WHEN THESE WO GOVERNMENTAL PROGRAMS DO NOT PAY UP TO THE COST, THE ONLY WAY THE HOSPITAL CAN STAY ALIVE IS FOR THE OTHER INSURANCES TO PAY MORE, AND THEY'RE NOT.

BUT THAT'S THE REASON WHY YOUR INSURANCE, MY INSURANCE, YOU KNOW, ERIC'S INSURANCE, THEY'RE GOING UP.

AND, SO, IT'S ALL CONNECTED.

AND THE QUESTION I'M ANSWERING THE MOST RIGHT NOW IS, I HAVE GOOD INSURANCE.

YOU KNOW?

WHY DO I CARE ABOUT THIS ISSUE OF HOSPITAL FINANCIALS?

WELL, MY MESSAGE IS CLEAR TO THOSE MINNESOTANS, BUT ALSO TO OUR LAWMAKERS, IF THAT HOSPITAL GOES AWAY, IT DOESN'T MATTER WHAT CADILLAC INSURANCE YOU'VE GOT, YOUR CARE ACCESS JUST WENT AWAY.

A RECENT NATIONAL POLL SHOWED 61% OF AMERICANS ARE PRIORITIZING AND THINKING ABOUT CARE AFFORDABILITY, WHICH IS WHAT I JUST TALKED ABOUT, AND CARE ACCESS.

THESE ARE THE TWO ISSUES AT HAND.

>> Cathy: Dr.

MATTSON, BEING THE PRESIDENT OF THE MINNESOTA MEDICAL ASSOCIATION, YOU REPRESENT A LOT OF INDIVIDUALS OUT THERE.

>> YES.

>> Cathy: SO IF HCMC WERE TO GO DOWN, HOW WOULD THAT AFFECT YOUR CONSTITUENCY AND SOME OF THE RURAL HOSPITALS?

>> WELL, SOME OF THE RURAL HOSPITALS MAY WANT TO TRANSFER PATIENTS TO HCMC, ESPECIALLY WITH THEIR RENOWNED TRAUMA UNIT AND THEIR BURN CENTER.

THAT WON'T BE ABLE TO HAPPEN ANYMORE.

WE'LL ALSO SEE THAT PATIENTS THAT USED TO GO TO HCMC WILL HAVE TO GO TO OTHER HOSPITALS.

SO SOME OF THE SUBURBAN-RING HOSPITALS WILL BE GREATLY AFFECTED BY PATIENTS WHO USED TO GO TO HCMC THAT WILL NOW NEED TO GO TO SOME OF THE THESE OTHER HOSPITALS.

AND SOME OF THE OTHER HOSPITALS ARE ALSO ALREADY FACING SOME FINANCIAL STRAINS BECAUSE THEY ALSO HAVE SIMILAR MIXES IN TERMS OF MEDICAID AND MEDICARE PATIENTS AND UNINSURED PATIENTS.

AND WITH THE ONE BIG BEAUTIFUL BILL ACT, WE SAW SOME MAJOR CUTS TO MEDICAID THAT ARE GOING TO AFFECT THE NUMBER OF PEOPLE ON MEDICAID AND PEOPLE'S ABILITY TO PAY.

SO IT'S OING TO HAVE RIPPLE-DOWN EFFECT THROUGHOUT OUR COMMUNITY AND INTO RURAL MINNESOTA.

>> Eric: COMMISSIONER, THE COUNTY BOARD, HENNEPIN COUNTY BOARD, OW OVERSEES THE -- >> YUP.

>> Eric: USED TO HAVE AN INDEPENDENT BOARD.

IS THAT CORRECT?

>> IT USED TO, YES.

>> Eric: YOU NEED TO GO BACK TO THAT?

>> WE ACTUALLY HAVE STEPPED IN AND WE HAVE STEPPED IN WITH COUNTY MONEY TO SAVE THE HOSPITAL.

SO LAST AUGUST, WE WERE TOLD THAT THEY MIGHT CLOSE IN DECEMBER.

COUNTY BOARD TOOK DIRECT CONTROL BECAUSE WE NEEDED TO GET CLEAR VIEW OF THAT FINANCIALS.

WE ARE MAKING PAYROLL RIGHT NOW.

EVERY TWO WEEKS -- >> Cathy: THE COUNTY IS MAKING PAYROLL.

>> YUP.

WHEN I TALK ABOUT OUR COMMITMENT TO KEEPING THE HOSPITAL OPEN, WE ARE MAKING A FINANCIAL COMMITMENT, WE BELIEVE IN THE HOSPITAL, WE BELIEVE IN ITS ROLE, WE KNOW IT'S ECOSYSTEM IS THE ENTIRE STATE.

BUT AT A CERTAIN POINT THERE'S A LIMIT TO HOW MUCH HENNEPIN COUNTY PROPERTY TAX OWNERS CAN PAY.

WE'RE MAKING THE PAYMENTS NOW.

WE'RE KEEPING THEM IN BUSINESS.

AND EVERYONE KNOWS, YOU CAN'T MAKE PAYROLL, YOU'RE NOT IN BUSINESS VERY LONG.

>> Cathy: 'M OLD ENOUGH TO REMEMBER COVERING THAT STORY IN 2007, WHEN THE MOVE WAS FOR GIVE HCMC MORE AUTONOMY.

TO ENSURE IT'S LONG-TERM VIABILITY.

AND I'M WONDERING, NOW THE COUNTY'S BACK TO OVERSEEING THE MEDICAL CENTER, IS THIS JUST A LOT OF CONFUSION OVER GOVERNANCE THAT DOESN'T HELP THE SITUATION TOO?

>> YEAH, I THINK PEOPLE CONFUSE THE TWO.

THEY THINK WE'RE IN IT BECAUSE OF ANY OTHER REASON THAN THE FACT THAT WE'RE TRYING TO SAVE IT.

AND WHAT PEOPLE IN 2007, WHEN IT GOT SPUN OUT LIKE A WHOLLY OWNED SUBSIDIARY, WE WERE ALWAYS THE OVERDRAFT PROTECTION.

SO IF THE HOSPITAL COULDN'T MAKE THINGS, THE COUNTY WAS ALWAYS OBLIGATED TO COVER.

THAT HAS NEVER BEEN A PROBLEM UNTIL THE LAST YEAR.

AND THAT PROBLEM IS INCREASING IN THE STRUCTURAL IMBALANCE GOING FORWARD ARE NOT BETTER, THEY ARE NOT LOOKING WELL.

>> Cathy: WHAT OTHER HOSPITALS ARE IN A SIMILAR SITUATION, MAYBE?

IT'S A LITTLE DIFFERENT GIVEN IT'S A COUNTY.

>> RIGHT.

YOU KNOW, THIS IS A SYSTEMIC CRISIS BECAUSE, LIKE COVID, SOME OF MY HOSPITAL LEADERS ARE TALKING ABOUT, THIS IS WORSE THAN COVID.

AND WHY IS THAT?

THERE ARE 31 HOSPITALS IN MINNESOTA RIGHT NOW THAT ARE FINANCIALLY DISTRESSED.

AND THIS IS ATIONAL DATA.

THERE ARE 18 RURAL HOSPITALS THAT MIGHT BE ON THE VERGE OF CLOSING.

I CAN TELL YOU THERE ARE SEVERAL HOSPITALS 'IN RURAL MINNESOTA RIGHT NOW WHOSE CEOs ARE SPENDING THEIR DAYS GOING FROM LOCAL BANK TO BANK TO BANK BEGGING FOR A COUPLE OF MILLION DOLLARS SO THAT THEY CAN KEEP GETTING THOSE AMBULANCES IN EXAMINE THOSE PATIENTS SERVED.

SO, THIS IS A SYSTEMIC CRISIS.

IT'S NOT JUST HCMC, IT'S NOT JUST NORTH, IT'S 31 OTHER HOSPITALS ACROSS MINNESOTA AND THE OTHER PIECE, TO Dr.

MATTSON'S POINT, WHAT WE'RE DEALING WITH RIGHT NOW IS JUST THE EARTHQUAKE.

>> YUP.

>> THIS IS NOT EVEN THE FULL STORY.

THE TSUNAMI, THE HR1 SUNAMI BEGINS IN OCTOBER OF 2026.

SO, IF WE MAKE IT THROUGH THE EARTHQUAKE, THEN WE'VE GOT TO BRACE FOR THE TSUNAMI.

AND I'M REALLY WORRIED.

>> IF I CAN ADD TO THAT.

>> Cathy: GO AHEAD.

>> FOR HCMC, US ALONE, TO YOUR POINT, WE ARE FORECASTING A $1.7 BILLION HIT TO HCMC OVER TEN YEARS.

IT STARTS LOWER, BUT IT ESCALATES.

SO $1.1 BILLION FROM MEDICAID REIMBURSEMENT CUTS, $600 MILLION FOR PEOPLE FALLING OFF MEDICAID AND BECOMING UNCOMPENSATED.

AND WE ARE SEEING THAT CATEGORY EXPAND.

AND THESE ARE PEOPLE WHO JUST CAN'T AFFORD THEIR CARE.

>> Cathy: SO WILL A SALES TAX INCREASE HELP REALLY?

I MEAN, THERE'S GOT TO BE SOMETHING ELSE HERE.

>> SO I THINK WHAT IT DOES, IT ALLOWS US TO GET OUR SHIP READY FOR THE STORMY WEATHER AHEAD.

RIGHT NOW WE ARE NOT AT ALL PREPARED TO TACKLE THAT.

>> IN FACT, YOU KNOW, YOU'RE MOVING TOWARDS SOLUTIONS.

WE DO HAVE POLICIES IN HAND RIGHT NOW BECAUSE THE LEGISLATURE IS IN SESSION, OUR TOP PRIORITY RIGHT NOW IS TO HAVE THE LAWMAKERS ON A BIPARTISAN BASIS STAND WITH THE NONPROFIT HOSPITALS.

SO BEYOND HCMC, WE NEED AN EMERGENCY UNCOMPENSATED CARE FUND THIS SESSION SO THAT THESE HOSPITALS I'M TALKING ABOUT THAT ARE ACTUALLY BEGINNING CLOSURE PROCEEDINGS RIGHT NOW, THEY CAN GET A CHECK RIGHT NOW SO THAT THEY CAN STAY IN BUSINESS FOR THEIR COMMUNITIES AND THEIR PATIENTS.

THE OTHER BIG PRIORITY WE HAVE, AND I'M REALLY -- YOU KNOW, THIS IS SOMETHING WE HAVE TO TELL MINNESOTANS -- BIG PHARMA IS OUT THERE RUNNING AD CAMPAIGNS AGAINST OUR COMMUNITIES' NONPROFIT HOSPITALS, YOU KNOW, AND WE CAN'T HAVE OUR LAWMAKERS AND OUR COMMUNITIES STAND WITH THESE TRILLION DOLLARS FOR-PROFIT BIG PHARMA COMPANIES STAND WITH THE NONPROFIT HOSPITALS.

>> Eric: IS COST CONTAINMENT POSSIBLE, REDUCE THE COST OF THE TREATMENT?

>> I MAY NEED SOME HELP ON THIS ONE.

I'M 0 NOT SURE THAT COST CONTAINMENT IS POSSIBLE.

>> YEAH.

OUR LEADERS, EVERY SINGLE DAY, THEY ARE PRACTICING OPERATIONAL EXCELLENCE.

>> WE'RE DOING OUR BEST.

>> BUT REMEMBER, MINNESOTA IS ONE OF THE HIGHEST PAID STATES FOR REGISTERED NURSES, WE HAVE HIGH LABOR COSTS.

THE OTHER THING AGAIN, WE SHOULD UNVEIL WHERE THIS LARGE INDUSTRY, WHERE IS THE MONEY?

THE MONEY IS WITH BIG PHARMA.

THE MONEY IS WITH PBMs, THE MONEY IS WITH FOR-PROFIT INSURERS.

THE MONEY IS NOT WITH THE FRONT-LINE NURSES, DOCTORS AND HOSPITALS.

>> Eric: TO BE CONTINUE.

WE'RE GETTING