Utah Healthcare Safety Net Summit

Cannon Health Building

288 North 1460 West, Rm 125

May 19, 2009

John Pingree, Intermountain Healthcare

Intermountain Healthcare

Community Benefit Programs

• Financial assistance (charity care)

• Community and school clinics

• Health initiatives (medical, oral, mental health)

• Foundations and giving programs

• Training and education program

• Research

Of all the forms of inequality,injustice in healthcare is the

most shocking and inhumane.

– Martin Luther King, Jr.

Quality of Life Disparities, Utah

Under AboveConditions 200% FPL 200%FPL Diabetes 12% 4% Hypertension 35% 18% High Blood Cholesterol 43% 32% Asthma 14% 12% Arthritis 38% 21%

Data Source: 2007 Behavioral Risk Factor Surveillance System, Utah Department of Health.

Intermountain Healthcare Financial Assistance ProgramMission

• Make care accessible to residents in the communities we serve regardless of race, religion, gender, age, national origin, physical or mental disability, veteran status, or ability to pay.

Intermountain Healthcare Financial Assistance ProgramTypes of Healthcare Services

• “Medically necessary” includes services for urgent and emergency conditions, for serious illness, or for attempting to rule out serious illness.

• “Generally available” includes basic diagnostic or therapeutic services. Excludes highly specialized, elective, and cosmetic services.

Intermountain Healthcare Financial Assistance ProgramIncome Qualifications

• At or below 150% of FPL receive full discount and asked to provide a minimum co-pay; and

• Between 150% and 500% of FPL receive partial discount based on progressive scale formula.

Intermountain Healthcare Financial Assistance ProgramHospital Responsibilities• Provide care in a timely way.

• Deliver care according to the best clinical judgment and medical policy.

• Apply health care resources equitably to those most in need. Encourage patients who can pay to do so.

• Communicate actively the availability of financial assistance to patients through a variety of channels.

Patient Interview Results, March 2009

How did you learn about the financial assistance program?

Intermountain Healthcare Financial Assistance ProgramPatient Responsibilities• Complete a financial assistance application accurately

and provide necessary documentation.

• Explore available sources of financial assistance, including government and private assistance programs. Intermountain will help patients apply for assistance from non-Intermountain sources.

• Contribute to the cost of care, based on ability to pay. Patients who are not able to contribute anything will not be required to contribute and will still receive care.

Patient Interview Results, March 2009

Were the forms easy or difficult to fill out?

Patient Interview Results, March 2009

Did you have to wait to receive non-emergent care until you had completed the financial assistance paperwork?

Patient Interview Results, March 2009

How long did you have to wait to get non-emergent care?

Recent Improvements to Process• Review of “Excluded Services” list; creation of

“Services Requiring Approval” list

• Established central Medical Review Team to assess most complicated cases and ensure equal treatment of patients across the system

• Instituted standard diagnostic services voucher program; community partners prequalify patients for financial assistance

Intermountain Healthcare Financial Assistance Program

Financial Assistance (Charity Care) & Bad Debt

1999 to 2008

Thank You