Harborview [Hospital] as busy as ever, even with more people insured [Seattle]

The Seattle Times ^ | 9/25/2014 | Tyrone Beason

[steve86]

With more people obtaining health insurance under the Affordable Care Act, places like Harborview Medical Center are providing much less “charity” (uncompensated) care. The Emergency Department there is as busy as ever, though.

---

Nowhere illustrates the complexity of delivering medical care in the era of health-care reform better than Harborview Medical Center’s 47-bed Emergency Department.

As King County’s largest safety-net hospital, Harborview’s specific mission is to care for patients who are most in need, giving it a disproportionate share of patients who are poor or homeless and uninsured.

Last year alone, Harborview provided $219 million in so-called “charity” care, nearly a fifth of all the nonreimbursed care provided in the entire state, according UW Medicine, the organization that manages the King County-owned hospital.

Many of those patients, even ones who don’t have urgent medical issues, wind up in Harborview’s ED.

The Affordable Care Act is supposed to ease the financial burden of unpaid hospital bills by expanding medical-insurance coverage to those who don’t have it, allowing hospitals to get compensated for the care they deliver to the poor.

The initial results are promising. Harborview and other safety-net hospitals across the nation are seeing plummeting numbers of uninsured patients in their emergency rooms so far this year, reducing charity-care costs and bolstering revenues. Harborview expects to spend $73 million on charity care in 2014, a huge drop compared to last year.

But even with increased reimbursements from the expanded Medicaid program for low-income patients, Harborview still expects to take an overall loss this year because of the cost of providing care for those who remain underinsured or uninsured, UW Medicine spokeswoman Susan Gregg says.

[steve86]

I detect some spin in this article!

[steve86]

PING!

Expanded Medicaid making up the difference, I guess.

[WhyisaTexasgirlinPA]

Here is the reason - with a $6,000 to $12,000 deductible, folks can not afford the battery of tests a doctor in his office might suggest - but if admitted to the hospital, that deductible can easily be absorbed and the government insurance pays the remainder of the bill. So, instead of writing off $30K, the hospital writes off the first $6K or so, which is the deductible. Instant savings of $24K....

[beelzepug]

Spin? It’s the Seattle Times, man! You should be puking-through-the-nose dizzy by now.

[steve86]

Not many admit to Harborview unless 1) They have no insurance 2) They Have Medicaid or Expanded Medicaid or Medicare 3) They have a life threatening burn or trauma. Virginia Mason, UW Medical Center, Swedish, etc., would cater to general clients.

[WhyisaTexasgirlinPA]

Is it the county hospital where they usually send those with no insurance?

[steve86]

More or less. Actually affiliated with University of Washington now.

Great pictures:

http://seattletimes.com/html/picturethis/2024575682_behindthescenesatharborview.html

[zeestephen]

This story was the Page One headline in today's print edition.

I actually stopped and read it at the news rack when I walked into Safeway.

I wish they went into more detail about Harborview’s funding.

I presume most of their deficit in past years was paid by the federal government.

Since many of their former patients are now on Medicaid, it looks like the same old money, but different agencies are writing the checks.

I think the future for “low cost” O-Care policies is going to be very short.

The cheapest policies are usually bought by the poorest people.

Those are the people least likely to be able to afford the high co-pays and deductibles.

They are going to postpone doctor visits until they are really sick, then they will show up at ER’s, where they cannot be turned away.

I think it's just a matter of time before half of all Americans are being treated - free of cost - at federally owned clinics and hospitals.

The “Death Panels” will be run by appointment clerks, who will decide how long you have to wait for your next doctor's visit.

[21twelve]

Thanks for that story and pictures. (My son was at SPU last year, and heading back tomorrow - photo of the victim from that hit home.)

I was there several years ago - turned out to be a non-issue injury, but two other hospitals didn’t want to risk being wrong, so the second one sent me to Harborview’s ER (otherwise it would have been a 6-hour wait he said!).

We were stacked up like cord wood on both sides of the hallways laying on our gurneys. LOTS of screaming, moaning drug addicts. With their ambulance drivers either trying to comfort them, or in the case of me - telling her to shut up. “Forget it Crystal. Remember last time when you tried to bite my arm?! Now shut-up.”

And just like in the photo, 4 to 5 crash-carts came flying down the halls. Had just come off choppers from a bad wreck - IIRC it had been in Vancouver, B.C. REALLY crazy place - I don’t know how those doctors do it.

[bjorn14]

I was at Harborview for 3 weeks in January 2006 for an infection. They tried to kill but I ended up having foot surgery by a world class orthopedic surgeon (He went to Walter Reed once a month to do operations on wounded soldiers) I had a job but no insurance, My Bill: $0. Great Staff.