The Enid News and Eagle, Enid, OK

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November 2, 2013

Oklahoma hospitals: Small fraction of revenue spent on charity care

(Continued)

Less than 1 percent

The study by Oklahoma Watch and the World shows wide variation among the state’s hospitals when it comes to charity care. At least 40 nonprofit and government-owned hospitals reported spending less than 1 percent of net patient revenues on charity care.

For-profit hospitals reported spending 1.1 percent on average on charity care, while hospitals owned by cities, counties and other government entities spent 1.7 percent on average. On the other end of the spectrum, the University of Oklahoma’s and Oklahoma State University’s teaching hospitals spent a combined average of 8.5 percent last year on charity care.

Ed Matthews, OSU Medical Center’s chief financial officer, said in addition to the hospital’s charity care, the university’s medical school provides care for the poor through various clinics. The hospital’s programs include a “fast track” emergency room to provide more efficient service to patients with more minor ailments and few health care options.

“We are and our partners are contributing significantly to the well being of Tulsa — I would venture to say much more than Brand X or Brand Y — and we’ve done it on a consistent basis,” Matthews said.

One hurdle hospitals have in accounting for the free care they provide is documenting that patients qualify.

Many hospitals require patients to provide proof that their income is low enough to be given free or reduced-price care. They say many patients eligible for charity care don’t go to the trouble of providing the documentation, meaning the hospital writes off some or all of the treatment as bad debt. In some cases it pursues collection.

OU Medical Center, a for-profit hospital that treats many low-income patients, takes a different approach. It requires patients to meet certain income thresholds to qualify for charity care, but does not require patients to submit tax returns or other proof of income because it can be a deterrent, said Michael Reese, the hospital’s chief financial officer.

“Generally speaking, we have moved away from any kind of means-testing in terms of ‘OK, show me your W-2, or last three pay stubs or the balance in your checkbook,’” Reese said. “It’s sort of an honor system.”

“You realize you’re going to get a certain population of patients who aren’t going to be able to pay, and to spend the time and effort to harass the patient to try and collect something … doesn’t make any sense.”

Kevin Bohlander, a 29-year-old Tulsan without insurance, said his doctor referred him to OU Medical Center for four days of expensive inpatient testing next month. Bohlander has a seizure disorder and his doctor wants to know more about what is causing it.

He said his mother called the hospital to make sure officials there understood her son did not have health insurance.

“They said it’s not a problem,” Bohlander said. “I’m looking at this like a blessing, it really is. Nobody has ever done anything like this for me.”

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