COMMONWEALTH Healthcare Corp. officials on Thursday asked the Senate Fiscal Affairs Committee to fund the CNMI’s only hospital adequately.
During a budget hearing in the Senate chamber, CHCC Chief Executive Esther Muna, Chief Strategy Officer Eleanor Cabrera, acting Chief Financial Officer Vince Camacho, and Chief Operating Officer Stephanie Crisostomo provided the Senate committee with an overview of CHCC’s current situation.
In a slide presentation, they highlighted the recent expansions at CHCC involving a drive-through pharmacy, the emergency department, the urgent care annex, a mobile clinic, endoscopy, the oncology clinic, the dental clinic, the outpatient department, radiology, and the dialysis center.
Cabrera said that in 2019, the hospital collected $88.5 million in revenue and spent $84.2 million; in 2020, its revenue was $86 million, but they spent $92.5 million; in 2021, the revenue was $108.9 million and the expenditure was $108.7 million; in 2022, the revenue was $128.4 million, but the expenditure was $138.1 million; and in 2023 the revenue was $116 million, but the expenditure was $123 million.
In fiscal year 2023, CHCC received $5.4 million from the CNMI government for the Health Network Program formerly known as medical referral services. But CHCC’s actual expenses for the HNP were $7 million, which means the hospital had to cover the $1.5 million shortfall from its own revenue.
Cabrera also presented the hospital’s uncompensated care costs. In 2021, the hospital incurred $5 million in uncompensated costs. In 2022, the uncompensated care cost went down to $2 million. These were lower figures compared to previous years because CHCC was reimbursed by the federal government for Medicaid presumptive eligibility that was made available to all due to the Covid-19 pandemic, Cabrera said.
But in 2023, the uncompensated care cost went up to $12 million. Cabrera noted that in May 2023, presumptive eligibility expired.
Muna told the senators that CHCC’s achievements “are a testament to the exceptional leaders and dedicated staff at CHCC.” Their commitment to the community, she said, drives them to improve the health of CNMI residents, and they believe that with sufficient funding “we will do even more.”
“We urge you to secure the necessary funds to cover the costs of services that CHCC has rendered to Medicaid patients from June 2023 to Sept. 2023 that we have yet to be compensated for,” she said referring to the $8.6 million in Medicaid funding.
Additionally, Muna said, CHCC requests adequate funding for medical referrals.
Lastly, she said CHCC asks for policy changes to continuously support the progress that it is making.
Muna noted that despite the increasing impact of social and economic factors on health in the CNMI, CHCC, as a safety net provider, must provide care to all no matter the level of care the patients need and no matter their ability to pay.
The chair of the Senate Fiscal Affairs Committee, Senate Vice President Donald Manglona, noted that in its submission, CHCC estimates to collect about $100 million in FY 2025. However, CHCC also projected to spend over $131 million in the next fiscal year, “which leaves an over $31 million shortfall.”
CHCC is a semi-autonomous public corporation whose main source of funding is patient revenues with Medicaid as the major payor.
