You probably have read or heard about the story in the Houston Chronicle that is critical of UTMB’s policies regarding care for indigent patients. The news report is based on the follow-up to a 2009 study, “Clearing the Fog,” that claims UTMB’s charity policy may violate state law and alleges that UTMB does not consider financial means when deciding who receives free health care. I am writing to set the record straight.
We are proud of the care we have provided for 120 years to people who cannot afford to pay for our services. We wish we could care for everyone in need, but the harsh reality is that we cannot. As is the case with most non-profit hospitals, the amount of free care we are able to provide has continued to drop, in direct response to the ever-growing number of medically un- and underinsured, shrinking reimbursements and rising health care costs. And, for us, there was the additional impact of Hurricane Ike.
In accordance with the state’s definition of charity care, UTMB provided $130.9 million in uncompensated care in fiscal year 2010. This information was documented in our official reports to the University of Texas System, the Texas Legislature and other state agencies. In addition, we continue to provide much-needed services to county residents through a variety of innovative programs, such as the UTMB-managed and -staffed St. Vincent’s Clinic, a Multi-share Plan that enables small local business owners to offer their employees affordable health care benefits, and a Community Health Program that helps economically disadvantaged patients manage their chronic diseases.
Like most organizations that deliver charity care, we make our general policies public and provide contact information for individuals who think they may qualify for or have questions about charity care. Our practices are consistent with the requirements of Senate Bill 1731 (“Healthcare Transparency”), the American Hospital Association’s Hospital Billing and Collection Practices and other health care industry guidelines.
It is important to note that charity qualification guidelines can be complex. Each patient’s situation is different and we make decisions on a case-by-case basis consistent with our policy and considering several factors. These include the nature and severity of the patient’s medical condition, his or her county of residence, whether he or she has been our patient before, and the potential relevance of the case to our training programs. Financial status is a consideration, but not the only one, and the first thing we do is help patients determine whether they might be eligible for financial assistance from other government or social service agencies.
These criteria apply to all potential charity patients, whether they seek treatment on their own or are referred to us by another provider.
As national news coverage illustrates (NYT Jan. 2, 2012 and NYT Sept. 30, 2011), ensuring equitable access to care goes far beyond the efforts of a single institution or the collective efforts of providers in a single region. We will continue working with our community partners to more effectively address the needs of our most vulnerable residents. We will also continue working with state and national leaders to inform policies aimed at ensuring equitable access to care. And, we will continue to manage our limited charity care dollars in a way that provides the greatest benefit to the greatest number of people.
Dr. David L. Callender