The Great Hospital Heist page 2Hospitals in New York receive $847 million annually from the State to compensate themfor bills that have not been paid by patients. These funds are generally referred to as ‘bad-debtand charity care’ funds or BD&CC. Inpatient and outpatient BD&CC charges are accounted forseparately. In order to calculate how much each hospital is due from the BD&CC fund, hospitalsreport to the Department of Health the total amount of hospital charges for which the hospital didnot receive payment. Bad debt is defined as amounts that are considered “uncollectible”. If anamount previously written off is later collected, it is reduced from bad-debt in future reports.Charity care, which is called “free care” in the DOH data, is the reduction in charges madebecause “the patient is indigent or medically indigent.” (Note: “Courtesy” discountsto physicians, employees, hospital board members, etc. cannot be charged to BD&CC
.
)
1
The Department of Health applies the individual hospital conversion ratio to thathospital’s total BD&CC charges to calculate the actual cost to that hospital for providingBD&CC. A complicated formula is then used to distribute the $847 million – the formula andamount are set by legislation – from the BD&CC pool fund to the individual hospitals; the funddoes not cover the full cost of BD&CC for most hospitals.This report uses the DOH data on BD&CC charges and costs to calculate the aggregateamount that hospitals charge in excess of the actual cost of providing care to patients who areuninsured or can’t afford to pay their bills. We call these amounts, ‘overcharges.’
Findings
The Public Policy and Education fund of New York (PPEF) analyzed the data reported by210 hospitals throughout to the New York State Department of Health for 2003, the most recentyear for which data were available. Based on these data, there are a number of findings aboutovercharges to self-pay patients in New York.INPATIENT OVERCHARGE RATE
!
On average, New York State hospitals charge self-pay patients 2.3 times more than thecost of providing inpatient care.
The cost of providing care is only 43% of the amountcharged for inpatient care.
!
The inpatient overcharge rate varies dramatically among hospitals.
o
Parkway Hospital, one of only two for-profit general hospitals reporting to theDepartment of Health, had the highest overcharge rate for inpatient care, chargingpatients 7.3 times the cost of providing care.
o
9 hospitals charged more than 4 times the cost of providing inpatient care.
1
NYCRR Title 10, Section 86-1.11(g)(1)(i)(a &b)
Please purchase PDF Split-Merge on www.verypdf.com to remove this watermark.
Leave a Comment