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WMC ‘uncompensated care’ on the rise

Published: 2009-12-29 08:02:16
By: Carol Crump | Casper Journal | December 23, 2009

In March 2008, Wyoming Medical Center anticipated uncompensated care at the regional hospital would top $30 million by the end of the fiscal year the following June. In December 2009, uncompensated care is more than $40 million and still climbing.

“We’re on the path to $51 million in fiscal year 2010,” the hospital’s chief financial officer Nancy Brandt said in a series of presentations to the Natrona County Commissioners and the hospital’s board of trustees and board of directors.

The hospital’s uncompensated care is a combination of direct charity care and bad debt. In 2009, the gross charges for total services were $342 million. All of the uncompensated care comes off the bottom line of the hospital.

Bad debt is the amount of charges patients don’t pay, even though they have a legal obligation to do so. The common misconception is that the rising amount of bad debt, which was $26.5 million at year end, comes from people who could pay and just choose not to do so.

According to Brandt, most bad debts come from those who would qualify for charity care if they provided the necessary information.

The hospital uses federal poverty guidelines to determine charity care. Most of the time, those with no insurance or federal payer, such as Medicaid, would have qualified for charity care if they applied, Brandt said.

Under the WMC charity policy that was revised three years ago, those individuals or families with incomes at or under 200 percent of the federal guidelines could qualify for full forgiveness of the cost of their care.

Even those with incomes between 200 percent and 275 percent of the federal guidelines can have their services discounted up to 50 percent.

The current guidelines define 200 percent of poverty as $21,660 for an individual and $44,100 for a family of four.

The direct charity care the hospital provided through December was $13.5 million. WMC is required to provide charity care for prisoners in the county jail and community members as part of its lease agreement with Natrona County. The county does reimburses WMC for prisoner care n $120,000 per year under terms of the 1995 lease.

WMC serves Natrona County’s citizens “first and foremost,” and 62.6 percent of the hospital’s gross charges are for county residents, Brandt said. The home county’s residents also are responsible for $26 million, 65 percent, of uncompensated care, including $1.4 million in trauma care.

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