Facing funding cuts from all sides, University Hospital officials delayed presenting a budget for next year as they searched Thursday for ways to cut expenses and maintain revenue.
University President Don Bray estimated the hospital will receive about $8 million less next year from Medicare and Medicaid, two of the hospital's biggest payers.
Hospital officials are also upset with Augusta city officials' proposal to cut in half the $2.5 million the hospital receives for caring for local indigent patients. Augusta commissioners are scheduled to vote on the cut when they pass a tentative budget Dec. 30.
The hospital had been expecting about a 10 percent cut in payments from the city for serving the indigent, which was capped in 1994 at $2.5 million. That amount does not cover the cost of caring for those patients, which is estimated at $4.2 million and could be as much as $8 million, Mr. Bray said.
"We certainly did not expect this kind of reduction in addition to what we agreed to three years ago," he told the hospital's board of trustees during Thursday's monthly meeting. The reasoning behind the cut, he said, is that city officials believe caring for those patients should be a state or federal responsibility.
"(But) there is nobody that's going to step in and take care of the local responsibility for these patients," Mr. Bray said. "Once that money is gone from the county budget, my concern is it won't be reinstated and there's nobody else to turn to."
The hospital received about $3.2 million last fiscal year from Georgia's Indigent Care Trust Fund, where hospitals pay into a fund that is then used to draw down a greater amount of federal matching money that helps reimburse hospitals for caring for poor patients.
"It's intended to not just pay for (unreimbursed costs) for Medicare and Medicaid patients, but for those who can't pay at all," said Laura Marshall, spokeswoman for the Department of Medical Assistance.
Without continued money for indigent care, Mr. Bray said, "long-term this will impact our ability to deliver those services." But because of federal rules, the hospital will still have to serve anyone "who shows up sick," he said.
Hospital officials will continue to talk with Augusta commissioners and plead their case before the Dec. 30 vote, Mr. Bray said.
But commissioners face some tough choices there, said Commissioner J.B. Powell, liaison to the hospital board. Commissioners don't want to raise taxes and must make cuts but it's possible the hospital's proposed cut could change, Mr. Powell said.
Still, the hospital faces a tough road next year with less money and is pinning its hopes on reducing expenses by $17 million, said chief financial officer Robert Taylor.
While it is "still premature to say" whether that would mean staff cuts, the administration is looking at a number of other options before it considers something like that, said Richard Parks, vice president of operations.