Hampton Roads health systems paid more for uninsured patients in 2016

The Hampton Roads region’s three main health care systems paid a larger community benefit in 2016 than the previous year, according to data from Riverside Health, Bon Secours and Sentara Healthcare.

Federal law requires not-for-profit health systems to provide medical care to uninsured and low-income patients and those with special needs. Providers call these costs uncompensated care and include them as well as other costs in their community benefit figures.

Health providers calculate their community benefit as medical care provided to these patients, money lost caring for Medicaid patients (Virginia pays providers 74 cents for every dollar they spend) and the cost for free community health programs, free vaccinations and other initiatives to improve health outcomes in the community, said Sentara spokesman Dale Gauding.

“There’s a significant percent of the patient population who don’t pay because they can’t pay,” Gauding said. “People with insurance and self-pay patients may pay higher bills to maintain operations so hospitals can provide mandated community benefits.”

Providers paid at least $1 million more for uncompensated medical expenses last year. Riverside had the largest increase, spending 11 percent more in 2016 than 2015. The health system provided more than $186 million in uncompensated care last year. The previous year it provided roughly $168 million, according to data from the health system.

The increase stemmed from a change in how Riverside handles financial assistance cases for unexpected medical costs, low-income patients, the uninsured or other patients who need help paying their medical bills, said hospital spokesman Pete Glagola.

“Patients were able to receive partial charity in 2016 as opposed to 2015 when it was all or nothing,” Glagola said. Riverside’s operation includes five acute care hospitals, a behavioral health facility and an extensive medical group of physicians and specialists in Hampton Roads.

Bon Secours, which includes Mary Immaculate Hospital among its facilities, provided around $72 million in uncompensated care last year and about $71 million in 2015. As the area’s only Catholic hospital, part of its mission is to care for the sick, even if they can’t pay.

However, uncompensated care costs are a concern because it’s a symptom of a much larger issue — the lack of access to high quality primary care and prevention, said Bon Secours spokeswoman Lynne Zultanky.

“When people without insurance coverage seek care, one of their few options is the emergency department for non-urgent issues,” Zultanky said. “When hospitals and health systems are uncompensated for the care they provide, it can limit access to all of us.”

Last year, Sentara reported a community benefit of $341 million. That’s $6 million more than 2015 and includes more than $310 million in uncompensated medical care, the hospital system said in a news release.

Gauding said the health system’s figures include not only charity and low-income care, but also bad debt and other costs. The hospital system runs 12 hospitals, trauma programs and educational programs, as well as financially supports Eastern Virginia Medical School in Norfolk.

“This whole idea of cost-shifting should be a concern,” Gauding said. “In order to give away $310 million or so in medical care, we have to make money somewhere.”

Canty can be reached by phone at 757-247-4832.