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Commentary: Non-Profit Hospitals Need to Toot Their Own Charity Horn
By Tina Eller, Senior Revenue Cycle Strategist, SearchAmerica
In 2008 you are hearing much about healthcare’s failures from the politicians, media, and others. In their minds, the healthcare community is doing a poor job and needs to be dramatically reformed. I couldn’t agree more. We have failed, but not where Americans may think we have.
Our ‘F’ belongs in our lack of public relations showing Americans the billions spent in charity care programs, and the associated belief that even non-profit hospitals are more focused on margin than mission.
Hospitals today do an outstanding job serving all of their patients. Most people don’t realize how exceptional our healthcare is until they receive medical care outside of the United States. These experiences, even in the most civilized nations, usually include lengthy waits for services (sometimes more than a year!), unclean or archaic facilities, and almost always bureaucratic staff with no hint of a smile.
We need to remind the United States that we should be proud of our independent healthcare services. In 2008, don’t just watch the news and let the politicians speak on healthcare. We have a responsibility to join in the discussion.
Who should the leading spokesperson be? Surprisingly, it may not be the hospital president or award-winning doctor, but its CFO and their revenue cycle staff. For who else could speak authoritatively on the dollar value of uncompensated care given by the hospital in recent years?
Charity Program – Huh?
If you ask the average American if non-profit hospitals in their area
provide services at no charge to the indigent population, they would most
often look confused at the question and certainly lay all credit for serving
the uninsured/underinsured community at the foot of government – ‘isn’t that
what Medicaid is for?’ Unfortunately, few people know about the billions of
dollars that hospitals, especially non-profits, give back each year to their
community in the form of free or discounted services.
It is like the saying if a tree falls in the forest with no one around, did it actually happen. If hospitals provide care on their own dime, and no one hears about it....did it actually happen?
Thus, in this year where healthcare and Iraq will dominate most discussions and debates, I urge you and your colleagues to make the billions spent on hospitals’ charity care programs a point a topic of discussion at your next social gathering, kids’ soccer match or class reunion.
Rumblings from Congress
& the IRS
You are no doubt aware of the increased scrutiny rising from Washington.
The updated IRS Form 990 and public statements by members of the Senate
Finance Committee are just several examples of the government’s increasing
monitoring of the nation’s healthcare providers. For the past year or more
Senate Finance Committee Chairman Max Baucus, D-Mont and Sen. Charles
Grassley, R-Iowa have spoken of the ‘magical’ 5% of annual revenues that
non-profit hospitals should be required to allocate to free care for those
unable to pay.
The bottom line is that the government is following poor public perception of healthcare and adding fuel to it with its current activities. Unfortunately, good news doesn’t sell...so we must do our part to comply with their new regulations but not lose focus of the bigger issue -- public opinion.
Choose More Than One
Just as doctors take a oath to serve those in need, healthcare
organizations have a shared passion, or mission, to deliver quality care to
its patients, to make a difference in their lives.
For non-profits, it’s not just about margin. Unfortunately the public, and to be honest sometimes our staff, forget that it is not the balance sheet alone that steers the organization.
More than ever, hospital CFOs need to picture themselves at a buffet not a wedding reception. They can freely choose multiple desserts in whatever quantity, not just a single piece of cake.
This is how they should view their hospital’s margins and charity programs. Hospitals can place both on their plate side-by-side, and neither is of more or less importance. In fact, just like ice cream and apple pie, both are better when served together.
How, you ask? When non-profit hospitals focus their collections on only those patients who are able to pay (removing those who qualify for charity and Medicaid in advance), their collections rates and margins dramatically improve while their bad debt decreases.
The revenue cycle is an important way to support a non-profit hospital’s mission. It needs to develop processes and use technology to identify and enroll all qualified patients for charity care, and focus 100% of its collection efforts on patients with the means to pay for services. Tax-exempt hospitals are not asked to give away the “farm” but to simply serve those who need assistance.
The bottom line is that hospitals need to be proud of the services they bring to everyone, whether they can afford them or not. In 2008, I challenge you to be more vocal about the positive aspects of our healthcare systems. After all, if we don’t toot our own horns it is clear that the politicians and media won’t.
Tina Eller is a Senior Revenue Cycle Strategist, SearchAmerica, and has worked in healthcare, both physician and provider spaces, for 15 years. Ms. Eller’s expertise is in helping organizations drive initiatives within the Revenue Cycle focusing on the self pay population and Consumer Driven Healthcare. She is a frequent speaker at healthcare forums as well as contributor to a number of healthcare publications on the topics of Revenue Cycle best practice, challenges in the industry, etc.
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