The Maryland Hospital Association wants to start a foundation that would support projects to care for the uninsured.
MHA President Calvin Pierson said the goal of the proposed Maryland Health Care Foundation was to reduce the number of Marylanders who lack health coverage, which has risen from about 650,000 in 1992 to 712,000 in 1995. While state reform of insurance for small employers has brought coverage to tens of thousands of people, Pierson said, others have lost coverage.
"We know in the economy that a lot of new jobs are low-wage service jobs that don't come with health insurance coverage," he said. "And companies of all size are increasingly using part-time workers or contracting out work."
Potentially, the foundation could benefit from another trend in health care -- the conversion of nonprofit hospitals or health plans to for-profit status, although Pierson said that was not an impetus for the MHA's proposal.
In other states, there have been controversies over who should reap the benefits of the assets of nonprofits that either convert to for-profit or are sold to profit-making companies.
In the case of a California Blue Cross plan that became for-profit, $3.2 billion went to a foundation to support charitable care.
According to the trade journal Modern Healthcare, 63 not-for-profit hospitals in the United States switched status last year, many through acquisition by investor-owned chains.
Maryland hospitals provide about $400 million a year in uncompensated care, an amount equal to about 8 percent of patient revenues, according to the Health Services Cost Review Commission.
The dollar figure has more than doubled over the last decade.
Bills have been introduced in the General Assembly to create the foundation, with public and private representatives on the board.
The Senate Finance Committee has scheduled a hearing on the proposal for today.
While the state would charter the foundation, Pierson said, "One of the things I want to emphasize is that we're not pushing for state funding." In particular, he said, the association does not want the foundation to be seen as an alternative or competitor to the program Thriving by Three. Proposed by Gov. Parris N. lTC Glendening, that program would provide free health care for pregnant women and children under age 3 who are not covered by commercial insurance or by other government programs.
Pierson said the association is proposing a quasi-public foundation so it could accept both government funds and private contributions. He said the plan for the foundation's charter was based on the Chesapeake Bay Trust.
"The foundation would not be a big operating entity," he said. Rather, it would receive contributions and make grants. Contributions could be for statewide efforts or targeted to a particular region, he said.
Another model is the Virginia Health Care Foundation.
Debbie Oswalt, executive director of the Virginia foundation, said it receives $2.2 million a year in state funds, and raises about six times that much in contributions, foundation grants and in-kind contributions, such as free care provided by doctors or hospitals or discounted coverage by health maintenance organizations.
In just over four years of operation, Oswalt said, the Virginia foundation has supported 75 projects to provide preventive or primary health care to the uninsured or in areas where there are not enough doctors.
"The idea," she said, "is keep people healthier, intervene earlier, treat it when it's at its most basic."
Pub Date: 2/13/97