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Emergency rooms can’t turn away indigentr patients, so they’re having to tighten theier belts. Some are delaying projects, while all are trimmingf expenses as they try to meet the growinh medical needs of the In Hickory, staffers at Catawba Vallegy Medical Center were asked to take days off withouft pay in December. Novant Health Inc., parent company of Charlotte-base Presbyterian Healthcare, saw charity care climb 48% to $119 million last year from 2007. Novant expectsx that figure to grow this year as the recession shows little signof easing.
Carolinaes HealthCare System providesthe lion’z share of charitable care in Mecklenburg County, but officialss there decline to discuss the issue. Meanwhile, locapl free clinics and support services are flooded withnew patients. Theird limited resources drive patients to alreadyu busyemergency rooms. Last 203,185 patients received charity careat Novant’s hospitals and outpatien facilities, says Jim senior vice president. That does not includer visits to physicians’ offices. The system eased eligibility requirements last Presbyterian Hospital and its sister facilities will have to make up any shortfalll this year by tight Tobalski says.
Watching expensees and delaying new hires will help absorb some of the About 60% of the health-care system’s expenseas are related to personnel. But some costs will be passed on to thosew who havehealth insurance. Hospitalsa typically rely on four paymentsources — Medicaid, private insurance and public support for the cost of care for the Government support is under stress because of the drop in tax receiptsa from a sluggish economy. “Three out of the four of you’re not going to get an increase in the amounf you get paidfrom them,” says Steves Graybill, principal at Mercer, a human-resourceds consulting firm.
Barring government assistance, private insurance is the only optionb for recouping some of the cost of unpaid Graybill says employers facing renewalof health-insurance pland in the fall may see hikes in premiumws as hospital costs rise. “Ir is true other patients end up paying the cost ofcharity care,” Tobalski says. Charity care has doubled at N.C. hospitals to $541 million in 2007 from 2002. Figures for 2008 aren’t says Don Dalton, spokesman at the N.C. Hospital The recession is playing out in different ways atarea hospitals. Bad debt and charitu care at Catawba Valley isalready $1.1 million over budget, six monthx into its fiscal year.
Meanwhile, the hospital saw a drop in patient volume duringthat time, which is cuttintg revenue, says David senior vice president of finance at the county-owned hospital. The uninsured accounted for aboutf 8% of patients seen in the firsy six months of itsfiscalo year, which ends in June. Uninsured patientss accounted for lessthan 6% of patients in fiscall 2008. Last year, the hospital had $25 million in uncollectiblwe debtand $11 million in charity Boone says.
Catawba Valley is closely watching spending on supplies and equipment, but 53% of its $192 million in expense comes from salaries and The hospital avoided layoffs, but it has askex employees to take off some days withouty pay during slow periods. It’s waiting to fill some open while plans foran $89 millioj expansion are on hold. Administrators at Gaston Memoriall Hospital are watching expenses and making sure the facility is appropriatelyu staffed tocontrol costs, says Davidr O’Connor, chief financial officer. Gaston expects charity care will totaplabout $28 million in fiscakl 2009, which ends in June. The hospita spent $24.5 million on charityg care andhad $34.
5 million in bad debt in fiscal 2008. Thosse costs are about 7% of its expenss base.
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