UNC Hospitals fighting uncompensated care losses

Until national health care legislation provides more patients access to insurance, UNC Hospitals administrators are hoping to use new revenue-generating tactics to dig out of a financial hole.

Since January, the hospital has lost $300 million in charity care, non-collectible debts and partial Medicare and Medicaid reimbursements, a significant increase from the $266 million they lost last year for the same reasons.

“We have very generous financial assistance policies,” said Karen McCall, vice president for public affairs for the UNC School of Medicine.

With the state subsidy for the hospital at about $36 million, it is up to the hospital to bridge the funding gap by overcharging patients who have insurance, said Dr. Bill Roper, dean of the UNC School of Medicine and chief executive officer of the UNC Health Care System.

UNC Hospitals aims to serve all patients regardless of whether or not they have insurance — a model that will not be sustainable in the long run.

“We want to be in a place that is true to our mission,” Roper said.

UNC is addressing the problem from two ends — making the process for those who can’t pay more efficient, and trying to attract more patients who can pay, McCall said.

The hospital is developing an online patient portal, to be launched in January, where patients can easily access information about bills and appointments, McCall said.

UNC is also working with those patients not covered by insurance.

“We’re asking people that we are assisting to partner with us to basically pay what they can pay,” she said.

Patients who filed for charity care or who are expected to not pay are now only allowed to make appointments within short periods of time to minimize their high no-show rates. This leaves more appointments open for patients covered by insurance, she said.

“It was critical for health care reform to take place for our survival,” McCall said.

“With health care reform we’re hopeful that people without insurance will have it within the next couple of years.”

More patients who are able to pay will lighten the load for everyone, said Sandra B. Greene, a professor in the health policy and management department at UNC.

Nationwide public hospitals with such mission statements face similar uncompensated care issues.

“National health care reform calls for more individuals to be covered by state and federally-funded programs,” said Jim Lee, vice president for Data Policy & Development at the Michigan Health & Hospital Association.

“Like other states, Michigan will continue to work to ensure those who are eligible for these programs are enrolled,” he said.

Contact the State & National Editor at stntdesk@unc.edu.