Is Medicaid Expansion the Answer for What Ails Rural Hospitals in Georgia and Mississippi?

Morgan Dunn, second from left, who owns Early Medical Center, spoke to the Blakely Rotary Club. Others from left are Rotary President Dave Atkins, Early Medical administrator Ginger M. Cushing and Early County Commission Chairman Hank Jester. Dunn lives in Magee, Mississippi.

A Mississippi woman with an extensive career in the healthcare industry has added another challenge to her executive portfolio in small-town Georgia.

And Morgan Dunn of Magee knows which medical program it will take to keep her facilities thriving for the long-term future: Expansion of Medicaid.

“Full Medicaid expansion would help us tremendously in Early County,” Dunn recently told a Rotary Club meeting in rural Georgia’s southwest corner.

Dunn last fall executed an agreement to purchase Early Medical Center in Blakely, which includes a 25-bed hospital, 117-bed nursing home, a full-scale physical rehabilitation unit and a separate family medical clinic.

Georgia recently expanded its Medicaid program on a limited basis to help small facilities like the one Dunn has taken over. Under the “Georgia Pathways” project, Medicaid recipients must meet a certain maximum family-income level ($30,000 yearly for four people), do 80-hours a month of qualifying activities, including work but also education classes, job training or community service.

The state estimates some 350,000 Georgians are eligible to enroll in “Pathways.” Georgia will spend $117 million of its own money the first year, with the federal government helping out with $227 million in matching funds.

Since Mississippi draws the largest federal cost-share in the nation, it likely would receive more than $400 million annually through a similar limited expansion.

Mississippi is now one of less than a dozen states that haven’t in some fashion enlarged its Medicaid rolls. The others are Wyoming, Kansas, Texas, Wisconsin, Alabama, South Carolina and Florida.

Dunn’s quick actions in Southwest Georgia toward turning around a facility operating on thin profit margins for years brought welcomed relief to one of Georgia’s most underserved regions for healthcare.

Georgia is ranked 46th of the 50 states in terms of access to quality healthcare by one poll. Another rating one year ago posted the state in the bottom 10 nationally for citizens’ access to top healthcare (Mississippi was last in that poll). That’s despite the Atlanta metro area having some of America’s best-rated medical facilities.

Almost as soon as Dunn was handed the keys to Early Medical Center in Blakely, she applied for and received a $1 million grant from the USDA to update the hospital and its auxiliary sites. Two new ambulances were ordered and placed in service, while another chunk of cash went toward replacing air-conditioning chillers.

One task ahead for the Mississippian with Georgia assets is to keep county residents at home when seeking medical care. “Residents of Early County will have to use this hospital and all of its services to help us out,” Dunn said. Many Early County citizens flock to more-advanced medical centers in nearby Dothan, Alabama, and Albany, Georgia.

That no doubt is a sentiment expressed by small hospitals across the rural South experiencing financial woes – much of it due to the lack of Medicaid expansion. One of my first recognitions of these problems came at Leland in the Mississippi Delta, which lost its small hospital some 40 years ago, no small tragedy.

Dunn’s family is invested in hospitals in Magee and Forest. She has been involved in myriad roles in the medical arena and knows how tough a business it has become.

It’s much easier to make money in the other family business. The Dunns own Zip’s Cafe in Magee, rated to serve Mississippi’s best hamburgers by two state cattlemen’s groups, according to Today in Mississippi magazine.

“If you make a lot of money in healthcare nowadays, it’s probably not legit,” she told her Georgia audience. “It’s a daily grind to make money now.”

---Mac Gordon is a native of McComb. He is a retired newspaperman.