Metro General Hospital Faces New Budget Scrutiny From Mayor

Mar 22, 2016

Nashville’s government-funded hospital that primarily serves the poor — Metro General Hospital at Meharry — is again seeking extra funding from the city.

But in a budget hearing Tuesday, Mayor Megan Barry grilled hospital leaders on their plans.

It has already been a rough several weeks for hospital director Joseph Webb. First, he asked the Metro Council for one-time emergency funding of $10 million, in part to be able to pay staff as the hospital’s cash on hand dwindled. After scrutiny, the council agreed.

Now, in the annual budgeting process, Barry questioned whether the hospital will ever make more money and become less reliant on a city subsidy.

The subsidy was $35 million last year and would remain the same this coming year — although Barry and city finance staff noted a lingering desire among officials to see that amount decrease over time.

“I’m trying to understand how the cash flow’s going to be any different — in six months or a year — than it’s been in the past,” Barry said.

Last year, hospital revenue from patients fell by $2.5 million. So Barry and Metro's chief operating officer, Rich Riebeling, sounded skeptical when Webb projected making an additional $6 million this year — an 8 percent increase in overall revenue.

“I’m still trying to get my arms around this idea that, if your patient population can’t pay to begin with, how being more aggressive gets more dollars in the door,” Barry said.

“Because,” Webb answered, “you have a portion of that population that does pay.”

“$6 million worth?” Barry asked.

Dr. Joseph Webb proposed his budget to Mayor Megan Barry on Tuesday.
Credit Metro 3

Webb’s answer was yes — he said the hospital has plans for attracting new patients who are not indigent, including creating an outpatient clinic.

He also told the council last month that the hospital is shifting away from a policy of assuming that its patients are indigent. Instead, it begins the billing process from a standpoint that patients can afford to pay something for care.

“We don’t plan to just sit back and wait for this to come up again and then request another supplement,” Webb told Barry.

Overdue Bills Linger

Webb did ask for another one-time jolt of $7.5 million, specifically to catch up on overdue bills that the hospital pays to vendors. As it stands, the hospital typically takes 80 days to pay its bills, but the cash infusion would reduce that average payment time to 30 days and align with industry standards.

“The vendors have become fairly aggressive in looking for shorter time frames for their payments,” Webb said.

Barry said she wants details from Webb in the next two weeks.

“Clearly,” she said, “I need more information.”