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St. James Provides Charity Care

June 24, 2010
Hospital ‘charity care’ up in Montana By Mike Dennison of The Standard State Bureau | Posted: Thursday, June 24, 2010 12:00 am But greatly varies among state hospitals HELENA — Charity care provided by Montana’s major hospitals to their poorest customers increased in fiscal 2008, but its level can vary greatly from hospital to hospital, says a report released Wednesday by Attorney General Steve Bullock. Bullock, whose office reports annually on “community benefits” provided by hospitals to justify their tax-exempt status, also said hospitals should ensure that charity care remains a big part of those benefits. “At the end of the day, these (nonprofit hospitals) are charities,” Bullock said in an interview. “It’s important for those charities to make sure … a critical function is to provide care for those who can’t provide for themselves. Charity care needs to continue to be an emphasis.” The 27-page document is the attorney general’s third annual report on Montana nonprofit hospitals’ finances and benefits to the communities they serve. Highlights of the report include: • The state’s 11 largest hospitals provided free care at a median of 2.43 percent of their operating expenses, up from 1.57 percent in 2006. St. James Healthcare in Butte had the highest proportion of charity care in 2008, at 3.55 percent of its expenses, and Billings Clinic was a close second at 3.48 percent. Eleven smaller hospitals, examined for the first time in this report, tended to provide a lower percentage of charity care. • Several hospitals have expanded the eligibility of their charity care since 2006. The hospitals with the most liberal charity-care policies are those owned by Catholic orders in Billings, Butte, Missoula and Miles City. • Community benefits reported by the hospitals, including charity care, were valued at $147 million for the 11 largest hospitals, or more than three times the value of their collective federal and state tax exemptions. • At the 11 large hospitals, charity care accounted for just one-third of the total “community benefits.” Other large benefit categories are unreimbursed costs of Medicaid (the state-federal program that pays medical bills for the poor) and “subsidized health services,” which are services that hospitals say don’t make a profit. Together, these latter two categories account for another 50 percent of community benefit spending, as reported by the hospitals. The report said these “more vague categories of ‘community benefits’ predominate at some hospitals,” and that sometimes “the benefit provided by these services in unclear.” St. Peter’s Hospital in Helena reported the highest amount of “subsidized health services” at $8 million, more than twice its amount of charity care and 60 percent of its community benefits total. Hospital spokeswoman Peggy Stebbins said St. Peter’s includes a dozen services in this category, from obstetrics to kidney dialysis. The hospital must subsidize their cost with revenue from other programs, yet still offers them because they’re needed in the community, she said. • Hospitals should do a better job explaining their charity-care policies to the public, either by listing them on the hospital website or presenting them in simpler terms. “Make sure that patients are aware of (the policy) going in, so we’re not grappling with the issue of individuals who ended up in ‘bad debt’ when they should have been part of charity care in the first place,” Bullock said. Linda McGillen, spokeswoman for St. James Healthcare in Butte, said the hospital is pleased to be at the top of the list on providing charity care. “Our mission is to help the poor and the vulnerable, and that’s what we’re doing with our charity care,” she said. St. James is seeing an increasing number of people without health insurance, or “self-payers,” and if they’re identified as someone without any money, their bills are written off, McGillen said. Jim Paquette, president and CEO at St. Vincent Healthcare in Billings, said the report indicates that Montana nonprofit hospitals are surpassing their obligations to justify their tax-exempt status. “Our charity care level continues to be consistent with other hospitals in the state, which correlates to our generous financial-assistance policies, as specifically mentioned in the report,” he said. Paquette noted that the report doesn’t show charity contributions by more than 100 physicians who practice at St. Vincent but who are not paid staffers. He also said “benefit” programs other than charity care help improve the health of the community, such as preventive, proactive health programs.