Hospitals facing new challenges in area of uncompensated care

(Elko, Nev. – September 15, 2003) In an article recently published in the Arizona Republic, writer Jodie Snyder refers to Phoenix-area hospitals and says, “Valley hospitals, struggling with a growing load of bad debt, are becoming tougher when it comes to getting patients to pay their bills and insurers to cover the hospital’s losses. That includes filing thousands of liens against patients, raising the rates charged to all patients, adjusting emergency-room procedures so patients must arrange to pay bills before they leave, and hiring collection agencies to press for payment.”

Also, in a recent announcement, HCA, the nations largest hospital company recently announced that for 2003 that their “bad debt” will comprise between 9 and 9.5 percent of net revenue for the balance of 2003. The term that healthcare organizations use to define the amount of care they provide that they are not compensated for is “bad debt.”

According to Northeastern Nevada Regional Hospital CEO Alex Poirier, this trend is beginning to impact the Elko community as well. “Just as in cities all across the country, we are having issues with bad debt. The largest percentage of our bad debt comes from people who frequent the emergency room as many as 20 – 30 times a month without any intention of paying their bill.”

Poirier adds, “Accordingly, we are having to adjust the way we deal with some of these issues. Some people think of healthcare as a ’right’ and not as a service to be paid for. Food is also considered a basic human need but no one, regardless of his or her ability to pay, could walk through the doors of a market , leave without paying for the goods, and not expect certain legal consequence. While we certainly are committed to meeting the needs of the community, it is imperative that we do so in a way so that the actions of a few do not jeopardize the access to care for all of us.”

Kerry Aguirre, Director of Community Relations and Business Development for Northeastern Nevada Regional Hospital points out, “Whether a patient is uninsured, insured but can not afford the co-pay, or never intended to pay the bill in the first place, the result remains the same. The rest of us make up the difference in higher insurance premiums and higher healthcare product/service costs.”

The recently refined policy at Northeastern Nevada Regional Hospital is as follows:

The Emergency Medical Treatment and Active Labor Act (EMTALA) requires that every ER patient be medically screened by a physician who will determine whether an emergency medical condition exists. After the physician determines that the patient does not have an emergency medical condition, insurance information and payment options are presented to the patient or qualified family member.

Patients should discuss and agree on a payment plan with the hospital. Patients making payments of any size without a signed agreement from the hospital business office will not be recognized as having a plan or arrangement for payment. If the account balance is not paid, in full, within six months from the first date of service, the balance is reviewed and turned over to a collection service contracted by Northeastern Nevada Regional Hospital. Prompt-pay discounts are available for patients who pay their balance in full within 30 days from the original date of service.

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