During 2007, FirstHealth provided $11,045,060 of medical assistance through Financial Assistance.
But the story doesn’t end there.
Annually, FirstHealth hospitals also absorb the costs of services provided to Medicare and Medicaid recipients that are not reimbursed by these governmental programs.
During 2007, FirstHealth absorbed the following:
- $16,336,410 for Medicaid patients
- $9,613,523 for Medicare patients
- $1,577,466 for patients from other government nonnegotiated plans
To those of us who manage the family checkbook or handle the monthly household budget, health care financials seem inconceivable.
Think back to our loaf of bread. Every person who steps into the grocery store to buy a particular brand pays the same price. If the grocery store were a hospital or a medical office, however, the fee might differ based on the individual patient.
The complicated economics of FINANCIAL ASISTANCE
When you visit the grocery store to buy a loaf of bread, it will probably cost you around a dollar. If you don’t have the dollar, you don’t get the bread. It’s simple economics.
Not so when it comes to health care.
Most Americans agree that all people should have access to essential medical services regardless of their financial situation. Caring for people when they are sick or injured is just the right thing to do.
Most hospitals help provide for patients with limited financial means and no insurance through special Financial Assistance programs.
Financial Assistance is a program for those who might otherwise fall through the cracks.
Anyone who visits a FirstHealth hospital for medical care is treated regardless of his or her ability to pay. Although an effort is made to collect a portion of the bill on admission or at discharge, the FirstHealth staff is trained to identify those who may need assistance. For some, this could simply involve establishing a payment plan that will fit in with the family budget. For others, the help is more complex.
When patients are unable to help with medical expenses, financial counselors meet with them one on one to identify any programs for which they might qualify. These include Medicaid, Vocational Rehabilitation and North Carolina Purchase of Care Services.
When necessary, the hospital itself absorbs some or all of the cost of care for those who meet designated criteria. The amount of assistance depends guidelines qualify for 100 percent financial assistance from the FirstHealth Financial Assistance Program. Patients whose income exceeds 200 percent may still qualify for assistance depending on their individual financial circumstance.
For patients who meet the requirements, the FirstHealth Financial Assistance Program will cover all expenses related to Emergency Room or Convenient Care and for unscheduled inpatient stays. The program will fund 90 percent of the expenses associated with:
- Inpatient Admission (scheduled)
- Surgery (scheduled, not to include cost of implants)
- Cardiology Procedures (scheduled, not to include cost of implants)
- Scheduled Outpatient Diagnostic/Therapeutic Services (Certain services do not qualify including specific behavioral services and elective, or cosmetic, procedures.)
Governmental programs, like Medicare and Medicaid, set payment guidelines each year. The reimbursement for care depends on the diagnosis of the patient. For example, if someone with Medicaid is hospitalized with pneumonia, the reimbursement is a specific amount regardless of the number of days the patient is in the hospital. If the costs of providing that care exceed the payment, the hospital has to absorb the difference.
It cannot charge the patient for those services. That’s against the law.
Across our nation, the number of the uninsured and underinsured is growing. A depressed economy and rising costs and unemployment contribute to the dilemma. Health care reform is a topic among most leaders, but it will take time to carve out a successful plan.
In the meantime, FirstHealth will continue to care for people. Regardless of their ability to pay.
It’s our mission, and it’s the right thing to do.