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After adjusting for the 25% increase in reimbursement rates to IRMC, the data suggest that some surrounding hospital reimbursement rates could still be over double those of IRMC. Since the County is self-insured, any change in expenses has a direct financial impact on the plan. If the Florida Blue reimbursement rates show similar differences between hospitals, a sale or lease to a partner could result in a significant financial impact to the County's health insurance fund if the partner's reimbursement rate with Florida Blue is higher than the current rate with IRMC. It is important to note here that one of the four finalists in the selection process does operate one of the hospitals located in St. Lucie County shown in the table above. If the reimbursement rates for that hospital or a similar rate were used at IRMC, the potential impact on the County's health insurance costs could be significant. It is also necessary to point out that staff does not have data regarding the reimbursement rates charged by the other three finalists. Those rates could be higher or lower than the rates shown at the table above. In summary, staff does not currently have access to reliable data to determine the amount of any financial impact. Based upon the current $1.5 million expenditure with IRMC, though, any significant change in rates from those currently charged by IRMC could potentially create a detrimental impact on the County's health plan. Hospital District Indigent Care Expenses The current fiscal year (2017/18) budget for the Indian River County Hospital District totals $12,807,297 (see attached). This includes funding for indigent care at the Indian River Medical Center as well as several other programs (e.g. State Health Department support, Visiting Nurse Association, Mental Health Association, etc.). The budget is supported primarily by ad valorem taxes, plus rental and interest income. The current year millage rate is 0.8894 mills, which provides about $13.6 million after accounting for early pay discounts, commissions and uncollectible amounts. The current year budget provides funding of $7,983,449 for indigent care at the hospital, with the remainder of the budget expended for other healthcare related services as listed above. Attachments: Preliminary Budget FY 2017-2018 Profit Loss Budget vs. Actual FY 2017-2018 Agenda Item January 16, 2018 52