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NEER c a' °oma Office of the z INDIAN RIVER COUNTY ORI�A ' ADMINISTRATOR \� Jason E. Brown, County Administrator Michael C. Zito, Assistant County Administrator MEMORANDUM TO: Members of the Board of County Commissioners FROM: Jason E. Brown County Administrator DATE: January 9, 2018 SUBJECT: Indian River Medical Center Potential Financial Impact on County Background On January 9, 2017, the Board of County Commissioners requested that staff provide a summary of the potential financial impact of a sale or lease of the hospital to another partner would have on the County organization. Additionally, the Board requested that staff provide information regarding indigent care expenses funded by the Hospital District. Please find a brief summary and analysis below: IRMC Potential Financial Impact on County The County provides health insurance to County employees as well as the five (5) Constitutional Officers' employees (e.g. Sheriff, Property Appraiser, etc.) through a self-insured health insurance program. About 1,550 employees and retirees are covered under the plan. Last year, total expenditures were about $18.5 million. Of that amount, approximately $1.5 million was paid to Indian River Medical Center (IRMC). In 2016, hospital officials provided information to County staff about the average reimbursement rates for IRMC as well as some surrounding hospitals. County staff's understanding is that the amounts represented average reimbursement rates reimbursed by private insurers for services per admitted patient. Furthermore, staff's understanding is that this is the same information that was presented to the Hospital District by the former hospital CFO, Greg Gardner. These rates were expressed as a percentage of the rates paid by Medicare. The table below contains this information as well as a comparison of rates among the local hospitals: 317