Presence hospitals see effect of Affordable Care Act; too early to tell for Carle

URBANA — The two Presence Health hospitals in Urbana and Danville gave out more than $9 million in charity care last year — about $2 million more than the previous year.

But Obamacare may be starting to have an impact on the demand for this help, one hospital official says.

Presence Covenant Medial Center provided $4.8 million in financial assistance to patients who couldn't pay all or the full cost of their hospital bills last year, compared to $3.7 million in 2012.

Its sister hospital, Presence United Samaritans Medical Center, provided $4.4 million in assistance in 2013, compared to $3.1 million the year before.

All charity care figures were given at what it costs the hospitals to provide the services, rather than reflected in what people may have been charged, and are included in Presence Health's latest Community Benefit report.

Deb Schimerowski, chief financial officer for the two hospitals, said the beginning of the year, when a requirement under the Affordable Care Act for everyone to have health insurance went into effect, had an almost immediate impact on both the Urbana and Danville hospitals.

Since Jan. 1, the two hospitals have seen a 4 percent shift in business away from self-pay patients — a large percentage of which apply for help paying their bills.

"We are seeing our Medicaid volume go up and our self-pay, charity and bad debt go down, because they do have some coverage," she said. "We started seeing it almost immediately in January."

The 4 percent change represents a "pretty big shift for us," Schimerowski said, adding that even 1 or 2 percent would be a big change because it means a switch "from no pay to some pay" for services.

The Carle Foundation also boosted its charitable assistance — from $35.2 million in 2012 to $44.3 million last year. That includes the amount of financial assistance given to patients of all Carle providers, including the hospitals in Urbana and Hoopeston, Carle physicians and other Carle health care businesses, Carle officials said.

The vast majority of assistance is provided by the hospitals, according to Carle Vice President Mike Billimack.

Carle also served more people with charitable assistance in 2013 — 27,400 patients, compared to 25,000 the previous year.

There was an increased need for assistance last year, Billimack said, but he and Dawn Walden, vice president of revenue cycle operations at Carle, said it's too early for Carle to evaluate the impact on the demand for charity care this year from more people with Medicaid or private insurance coverage as a result of the Affordable Care Act requirement.

Part of that will depend on the kind of coverage patients purchased and how well they'll be able to afford the costs, such as copayments and deductibles, that come with it, Walden said.

"These are things we just don't know," she added.

Billimack said Carle is always evaluating its charitable assistance programs according to what's going on across the state and in the health care industry in general.

"We are constantly looking at the program, how it fits, how we can do better," he said.

Other information supplied by Presence Health for the Urbana and Danville hospitals:

Covenant and United Samaritans combined also picked up $14.7 million in unpaid costs for patients in the Medicaid program last year and together provided $3.4 in other community benefit services such as education for health professionals and programs to improve community health. That additional information wasn't yet available from Carle.

A new state law in 2012 broadened and defined the terms of charity care for hospitals in Illinois, and requires non-profit hospitals to provide charity care that equals or exceeds the value of the property tax exemptions they receive.

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