Patients Rely On State, Fed Plans

Hospital racks up $2.3 million in uncompensated care as pool of people with private insurance sinks

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The recession has cost some Rim Country residents their medical insurance, but Arizona’s Health Care Cost Containment System (AHCCCS) for low-income people has absorbed many of those patients, according to trends noted at the Payson Regional Medical Center.

About 22 percent of the patients at the medical center qualify for AHCCCS coverage compared to 18 percent in 2007, said Chris Wolf, director of the medical center.

In the meantime, the number of people considered “self-pay” dropped from about 7 percent to about 4 percent.

Patients with private insurance account for 25 to 30 percent of the total, said Wolf – which is less than half the comparable figure nationally.

“The burden of uncompensated care is still large,” said Wolf, “but what we’re seeing is more people moving from self-pay to Medicaid (AHCCCS). So whatever criteria the state has in place seems to work to support those who are uninsured or underinsured.”

Together, the two main public insurance programs cover the bills for two-thirds of the center’s patients, which includes both AHCCCS for low-income patients and Medicare, which covers people with disabilities and people older than 65 without regard to income.

The local figures reverse the percentage nationally, where two-thirds of the people with medical coverage have private insurance, according to the federal Centers for Disease Control.

The ability to get people into the AHCCCS system has kept the hospital’s bad debt and charity care from spiraling out of control, said Wolf. The hospital donates or writes down about $2.3 million in bills annually, a figure that has held steady for the last few years.

That represents about 5 percent of the medical center’s operating expenses, said Wolf. Wolf estimated that care given to non-citizens without medical insurance accounts for perhaps 20 percent of the $2.3-million total for uncompensated care — which remains far less than the 40 to 60 percent figure for hospitals closer to the U.S.-Mexican border.

The high percentage of Medicare retirees in the area and the hospital’s success in getting people qualified for AHCCCS has helped cushion the impact of a doubling of unemployment and a rise in the ranks of the medically uninsured statewide.

According to a report by the Centers for Disease Disease Control based on Census Bureau interviews about 11 percent of Americans have had no insurance for the past 12 months and about 19 percent had no insurance for some portion of the past year.

Arizona has among the highest rates in the nation. The survey showed that 25 percent of Arizonans had no medical insurance at the time of the interview – including 20 percent of those younger than 18 years of age.

Only Florida’s 27 percent and Texas’ 29 percent rates came in higher than Arizona. Nationally, 20 percent of those surveyed had no insurance at the time of the interview, according to the CDC study.

The federal Department of Health and Human Services recently released figures on medical insurance trends, with a state-by-state breakdown.

Those figures include:

• About 3.5 million Arizonans get health insurance on the job, paying an average family premium of $13,362.

• Average health insurance premiums have risen 97 percent since the year 2000.

• About 19 percent of middle-income Arizona residents spend more than 10 percent of their income on health care.

• Paying the medical costs for people without insurance adds an estimated $1,700 annually to the cost of insurance for people with coverage.

• About 14 percent of Arizona residents say they skipped going to the doctor as a result of the cost.

• The percentage of Arizonans with coverage provided by their employer declined from 60 percent to 55 percent between 2000 and 2007.

• Blue Cross/Blue Shield provides 43 percent of the private insurance in Arizona.

• From 2001 to 2008, the percentage of Arizonans without medical insurance increased from 20 percent to 25 percent, while the number with job-based coverage dropped from 68 percent to 60 percent.

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