Caring for Vulnerable Populations -- $167 million

BJC HealthCare hospitals and service organizations care for all patients, regardless of their ability to pay. Collectively, BJC provided $167 million in charity care, unreimbursed Medicaid and other uncompensated care during 2007.

Relieving Financial Strain
T and his wife J were retired. They relied on their monthly Social Security benefits for their everyday needs and while they were healthy, it was a reasonable plan. But when T was diagnosed with cancer and J broke her arm, their tenuous financial stability quickly collapsed. Medicare covered much of their health care costs, but the deductibles and co-pays mounted quickly. Not knowing where to turn, J called Christian Hospital in desperation: “We have always paid our bills and paid on time, but this is more than we can handle.” Financial assistance counselors at the hospital worked with the couple to get a full understanding of their financial situation. The couple’s remaining balance of $5,167 after Medicare was absorbed as charity care.

At Alton Memorial Hospital, a patient’s illness ultimately led to medical disability. She wrote this message in appreciation for the $8,330 in charity care for accumulated medical bills and for the guidance she received in applying for disability: “Thank you so much for assisting me with my hospital bills. When I became ill and was not able to return to work, I worried constantly how I was ever going to be able to pay all of my medical bills. You were so kind in reassuring me not to worry and helping me apply for financial assistance. I appreciate the forgiveness of my bills during my time of need. I was eventually able to qualify for disability, and I am now on Medicare. Thanks again.”

BJC hospitals provided $53.3 million in charity care in 2007 to patients who were unable to pay for any or all of the care they needed. With a 25 percent automatic discount for self-pay patients and a sliding scale based on federal poverty guidelines and family size, BJC seeks to work with patients needing financial assistance on an individual basis. In addition to reduced bills, financial assistance ranges from determining if a patient qualifies for state or federal programs, to arranging manageable long-term payment plans to complete forgiveness of payments.

Beyond charity care and financial aid, BJC provided $45.6 million in unreimbursed Medicaid during 2007.

BJC also absorbs the cost of caring for patients who end up never paying their co-pays, deductibles or health care costs for a wide range of reasons. These patients receive needed medical services and, in fact, receive the equivalent of charity care but because they have not provided financial information, they have not yet been identified as qualifying for charity care. BJC provided $68 million in other uncompensated care at cost during 2007.

BJC supports the Medicaid program in Missouri through the Federal Reimbursement Allowance (FRA). Under the FRA, hospitals are assessed an annual tax based on revenue which is then used by the state to earn federal matching dollars to maximize payments to the Medicaid program. Considered general revenue by the state, FRA has become the third-largest source of Missouri’s general revenue. BJC funds approximately 20 percent of Missouri’s FRA annually.