By October, 752 patients requested assistance. The figure dropped in November, but the seemingly good news was tempered by the fact that November had fewer work days.

OHSU isn’t alone.

As the economy weakens and jobs evaporate, Portland hospitals say more patients are asking for, and receiving, financial aid. The surge in charity care isn’t a problem just for hospitals. The costs eventually get passed on to paying customers, notably businesses that insure employees. The increase in charity care is also having a big impact on hospital bottom lines as health providers tighten budgets.

It’s not just a Portland problem.

Nationwide, the American Hospital Association reports most hospitals are seeing an increase in the proportion of patients unable to pay for care. A survey of 557 hospitals indicated demand for uncompensated care increased 8 percent in the third quarter compared to the same period in 2007.

The unemployment rate is the biggest driver of charity care, said Diana Gernhart, associate hospital director, finance, for OHSU Healthcare. Companies are also increasingly asking workers to shoulder a bigger load of health care costs. The result is that more low-income workers need help.

“We know demand will continue to rise and the payer mix will continue to shift,” Gernhart said.

Two weeks ago, OHSU announced sweeping cuts to cope with a $30 million gap caused, in part, by lower-than-expected growth in paying patients.

An anticipated increase in charity care prompted Providence Health and Services to boost its $2.1 billion 2009 operating budget, which starts Jan. 1, by $30.6 million, said Terry Smith, chief operating officer for the nonprofit health system. In Portland, Providence operates three hospitals and more than a dozen clinics.

The decision to boost the budget for uncompensated care came after Providence had a 25 percent increase in charity care in the past year. Its twin cousin, bad debt, climbed 15 percent.

“That growth rate is accelerating during the year,” Smith said.

The hit means Providence must trim discretionary spending. That spells reductions for travel, special events and consultants. Some capital projects are also on hold.

Legacy Health System sees both charity care and bad debt increasing as a percent of revenue, said Scott Johnson, vice president for finance for Legacy Health System.

Increasingly, Legacy is unable to collect from patients who have both jobs and health insurance. That’s because as employers struggle to contain health care costs, they increase employee matches, deductibles and co-pays.

A patient who once paid 10 percent of a bill may now be responsible for 30 percent. Johnson said a great deal of Legacy’s charitable care is for people with health insurance.

Legacy’s fiscal year starts April 1, so its 2009 budget is in development. It will likely include increases for delinquent accounts.

Jim Gersbach, spokesman for Kaiser Sunnyside Hospital, said the number of visits by non-Kaiser members is on the rise, which prompted the insurer-run hospital to boost the number of counselors to help usher patients through the financial assistance process. Non-Kaiser members account for 17 percent of visits to Kaiser Sunnyside, up 6 percent in a year.

“A lot of people come in and say, ‘I don’t know how I’m going to pay for it,’” he said.

It’s too early to determine what impact the economy is having on emergency rooms,. Hospitals expect visits to increase as uninsured residents wait longer for treatment.

Despite this week’s bone-chilling weather, which has filled emergency rooms with twisted ankles and broken legs, increases are anecdotal.

Visits to OHSU are approaching 38,000, slightly higher than last year.

Gernhart said population increases could account for the larger number of patients, along with the new emergency room for children.

Kaiser Sunnyside is on track for 40,000 visits, Gersbach said. In February, the emergency room expanded to 40 beds from 19. Although a greater percentage of patients are not Kaiser members, the overall number of visits is steady.

By Wendy Culverwell Business Journal staff writer - Portland Business Journal
This e-mail address is being protected from spam bots, you need JavaScript enabled to view it | 503-219-3415

 Source: http://portland.bizjournals.com/portland/stories/2009/01/05/story6.html?b=1231131600^1755560

All contents of this site © American City Business Journals Inc. All rights reserved.

Email (will not be published)

Name

Title

Comment
 remaining characters

Post