LEXINGTON — Affordable Care Act premiums are falling in several areas across the United States in 2020, the Lexington Regional Health Care board of directors took a look at the shifting landscape of healthcare premiums during their board meeting on Tuesday, Nov. 26.

The snowfall on Tuesday ensured the LHRC board meeting was shorter, but Chief Financial Officer Wade Eschenbrenner gave an overview of premiums and Medicare Advantage.

"Nationally, the average unsubsidized premium for the lowest-cost bronze, silver, and gold plans are decreasing by just under 3 percent from 2019 to 2020, and the average benchmark silver premium – on which subsidies are calculated – is dropping by somewhat more, about 3.5 percent," according to the Kaiser Family Foundation report on ACA premiums.

The KFF report continued, "In general, this could mean the tax credit covers somewhat less of the premium for subsidized enrollees who enroll in the lowest-cost plans. However, premium changes vary by geography, so whether enrollees will see their premium payments increase or decrease for 2020 will depend on how benchmark premiums are changing and how premiums for plans at their preferred metal level are changing in their county."

In Dawson County, a monthly premium after tax credit for the lowest cost plan for a 40-year-old with $30,000 in income in 2019 was $207, by 2020 it will be $191, a change of seven percent.

Eschenbrenner described Dawson County and several of the surrounding counties as, "stable."

Discussion also centered around Medicare Advantage.

According to, "Medicare Advantage Plans are a type of Medicare health plan offered by a private company that contracts with Medicare to provide all your Part A and Part B benefits. Most Medicare Advantage Plans also offer prescription drug coverage. If you’re enrolled in a Medicare Advantage Plan, most Medicare services are covered through the plan. Your Medicare services aren’t paid for by Original Medicare."

Eschenbrenner quoted a Forbes article about the hidden costs surrounding Medicare Advantage. The premiums are usually lower than other Medigap plans.

He said the plan can be less expensive upfront but, according to the Forbes article, there are other costs out of pocket such as copays, coinsurance and out-of-network costs. "People at times are surprised by how high their copay is," Eschenbrenner said. It is also important to know whether your provider will accept these plans as many places don’t accept, or have limited acceptance as compared to the traditional Medicare plans with a supplement.

"We have a pretty high percentage of Medicare Advantage users in the community," Eschenbrenner said. He estimated around eight to ten percent of their patents use Medicare Advantage.

Eschenbrenner shifted to presenting the hospital’s financials from October. He said LRHC is fully live with Cerner and everything is now being run through this system.

The gross revenue for LRHC continues to trend upward, the number in October was around $3.4 million. He described the hospital as being between the busier summer period and equally busy flu season.

Eschenbrenner cautioned the board their number for days in accounts receivable was higher, and is likely to grow higher before the end of the year. This is due to the Cerner transition and was expected, he added the billing will soon be getting back to normal.

LRHC board chairperson Rob Anderson described this time as "transitional," but said it is what the board expected with the transition to Cerner.

There was one item which met the board level for charity care, which was for $12,730.46, which the board approved.

During the administrative report Chief Information Officer Robb Hanna commented on a Family Medicine Specialists’ phone call back issue which had been brought to attention by board member Pam Trampe.

Hanna said a change had been made to the system which, at the moment, seemed to clear the issue up.

A downside of the Family Medicine Specialists’ call system is it is automated, Hanna said. He added not everyone wants to hear a recording and would prefer to speak to a staff member directly.

The issue is, Hanna said, the hospital would have to hire between 10 and 11 people to man the phones during their peak hours.

However the issue with the call back system has been addressed. Hanna said LRHC wants to know about these issues so they can get them fixed.

The board also improved appointments and reappointments, which included

- Christopher Seip, MD

- Christopher Souchek, CRNA

- Kevin Gillespie, MD

- Kim Coleman, MD

- Peter Abasolo, MD

- Robert Burgess, MD

- Thomas Saylor, MD

Afterward the board went into executive session to discuss potential litigation and contracts, Anderson said no action was taken.

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