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Oregon Road Conditions & Cams Email Story to a Friend November 7, 2005 Providence settlement takes effect By BILL KETTLER Mail Tribune Providence Medford Medical Center managers say it’s hard to predict how many people in Southern Oregon will benefit from the settlement of a class-action lawsuit about the rates Providence hospitals charged uninsured patients. The settlement announced last week will give uninsured patients in Southern Oregon an 11 percent discount on their hospital bills, which is the same discount that most insured patients get under Providence’s "preferred provider" rates. The agreement applies for the next two years and retroactively for four years. Many former patients who might be eligible for reimbursement are no longer on the hospital’s active account files, said Mike Strasser, Providence Medford’s assistant administrator of fiscal services. "We won’t know for a few months how many people will be affected," Strasser said. The agreement applies only to uninsured patients who paid out of their own pockets for health care. Strasser said only about 6 percent of Providence Medford’s patients fall into the uninsured category. The hospital treated about 45,000 outpatients in 2004 and about 7,000 inpatients. Advertisement At issue in the lawsuit was Providence’s practice of discounting hospital charges for patients who have health insurance. Insurance companies routinely negotiate lower rates for their clients in exchange for the volume of business they bring to a hospital. "It’s not that we’re charging these (uninsured) individuals more," said John Schwartz, interim chief executive for Providence Medford. "They don’t have the benefit of a group (insurance) to negotiate a discount." Providence was not unique in negotiating charges with insurance companies, said Mike Bond, chief executive officer of PrimeCare, the association of Jackson County physicians. "All hospitals do this," Bond said. "The case just happened to be brought against Providence." A number of similar class-action lawsuits have been filed in other states. A similar suit has been filed against Legacy Health System of Oregon. The settlement also codifies who will qualify for additional discounts at Providence hospitals. Patients whose income is 400 percent or less of the federally defined poverty income will be eligible for larger discounts. The federal poverty income is currently $9,570 for an individual; $12,830 for a couple; $19, 350 for a family of four; and $25,870 for a family of six. Schwartz said the amount of financial assistance will be determined in part on whether a patient has other assets in addition to earned income. Patients with an income of less than 200 percent of the poverty level and no other assets will pay nothing. Strasser said Providence Medford provided about $4.4 million in charity care in 2004, and projections indicate the cost of charity care will rise to $5.5 million in 2005. Nationwide, the cost of uncompensated or uninsured care amounts to about $35 billion, said John McConnell, a health care economist at Oregon Health & Science University. "That has to be paid in some way," McConnell said. "Eventually it’s paid in health insurance (premiums) or government programs." A study commissioned by Families USA, a consumer advocacy group, estimated that a family of four in Oregon pays $1,128 in additional health insurance premiums to cover the uninsured, and could pay as much as $1,886 extra by 2010. The "cost shift" also surfaces in the form of higher deductibles and co-payments, at the same time that the list of covered services shrinks. While the Providence settlement may make health care more affordable for some people, lawsuits alone aren’t going to solve the problems of people who can’t afford medical care, said Russ Danielson, chief executive of the Providence Health System in Oregon. "We need comprehensive legislation to do that," he said. For more information about the settlement, see the Providence Web site:www.providence.org/oregon Reach reporter Bill Kettler at 776-4492, or e-mail Providence settlement takes effect ">[email protected] . All claims in the Providence uninsured class-action settlement are being handled by phone. Call 1-866-747-2455 for more information about the lawsuit, to order a claim form or to find out who is eligible. In general, a claimant must have had medically necessary care at a Providence hospital in Oregon after Dec. 7, 2001. Only patients who had no health insurance are eligible, and only those who did not already receive full charity care. Mail Tribune Home | Local News | Sports | Business | Obituaries | Life | Opinion AP News | Archives | Site Map | Community | Classified Copyright © 1997-2005 Mail Tribune, Inc. All rights reserved. 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