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Hospital social workers 'get creative' for uninsured patients |
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Ace Stryker - Daily Herald
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Every week, the emergency room at Utah Valley Regional Medical Center sees illegal immigrants and other uninsured victims of trauma and sickness.
As part of the nonprofit group Intermountain Healthcare, the hospital treats everyone who walks through its doors. But many, after receiving immediate care, need follow-up attention in a skilled nursing or rehab facility or through home health care. In most cases, that's easy enough to arrange; but among patients without a means to pay the sometimes mountainous costs, it can get tricky to find services willing to take them. That's where UVRMC's team of 10 social workers comes in.
"There is sometimes difficulty when there's not insurance, no matter who they are," said Doug Huff, a discharge planner with the hospital's cardiac areas.
A trend that has been called "cold" and "disturbing" is growing from scattered hospitals across the United States: Required by federal rules to help arrange follow-up care, some health care facilities are deporting foreign nationals because there is nobody willing to accept them. The New York Times reports that dozens of victims are being forcefully repatriated each year from places like Phoenix, San Diego and Fort Lauderdale, Fla. But that has never happened in an Intermountain hospital, spokeswoman Janet Frank said -- although some hospitals have arranged transportation for patients from out of state when they are discharged.
"We never ask the status," she said. "We don't know if they're legal or not legal."
Kimball Anderson, chief operating officer at Mountain View Hospital in Payson, said his staff has never considered deporting an illegal immigrant after treatment.
"I think that's kind of cold," he said. "We've had to arrange transportation for patients that are indigent -- not necessarily illegal."
That recently included a family from Washington who needed medical attention after suffering a car crash. Mountain View bought the family bus tickets home, Anderson said.
At Mountain View, social workers are available to help uninsured patients after acute care, but employees more often provide patients with information and let them make their own choices, he said. If follow-up care can't be arranged, community clinics often help out.
"There has never been a situation, to my knowledge, where we have arranged transportation for someone out of this market or out of this state because we didn't want to take care of them," he said. "I don't think there's a hospital in the state of Utah that would do that."
There are a variety of possible solutions in "challenging" situations involving uninsured patients, Huff said -- but only some of them work, and only some of the time. One of the best solutions is to get these victims public assistance, although that's really only practical for some patients because it takes so long to secure it, he said.
"If a person's been involved in a trauma and they are disabled, we can begin the process of trying to get them Medicaid through the state, and maybe the right links to get them into the Social Security system," he said. "We look at those early on to see if we can kind of get the ball rolling."
Often, there is not enough notice. It then falls to the hospital to find services willing to take patients without guarantee of payment. The likelihood of success depends largely on the health of the patient, Huff said.
"Most of the skilled nursing facilities are willing to look at the case with the possibility that Medicaid isn't for certain yet, but it will probably come," he said.
Sometimes, though, when you've got to advocate for your patients, it comes down to simple begging.
"A lot of times you have to get creative, and you have to talk to facilities and get on bended knee and say, 'Hey, can you help us out?' " he said.
Failing that, there are several other nonprofit groups in the area that frequently help with home health care, Huff said. But if it gets to that point, it's not unheard of for the hospital to keep patients until they're healed -- Huff offered the example of a patient who stayed an extra six weeks for antibiotics.
"Many times, we just have no other options," he said. "We have to make sure that their antibiotics are taken care of."
Mountain View also participates in a program of the South County Health Coalition in which health care providers share the risk associated with uninsured patients, making it more manageable, Anderson said.
"They've come up with sort of a rotating plan where nobody's taking on an unnecessary burden," he said. "It's a good thing."
• Ace Stryker can be reached at 344-2556 or
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Article views: 2,939
Discuss (9 posts)
| prisonpig
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Aug 18 2008 19:07:17
Cici wrote:
I don't believe that the general public knows this well kept secret ~ anyway the citizens of this great country don't know this well kept secret, but illegal aliens have only ONE Medicaid benefit. That is if they have an emergency which require hospitalization, life or death...then the bill is paid fully by WE the generous tax payers of America. Now, if I, a US Citizen had an accident and had to be admitted to the hospital in a life or death situation and had no insurance, guess who pays for that?? You're right ~ ME for the rest of my freakin life!! That is why so many illegals use the ER as a clinic!! WE THE PEOPLE need to get OUR act together and let the politicians know that they will not be voted for another term if they continue to esteem those that have come here illegally, over their own citizenry! It is pitiful!
Well said! Personally, I believe ALLthose who have been in office for the past few years regardless if they are Republican or Democrat need to be voted out. They have proven they don't serve the people of this country. FIRE EM ALL!!
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#387892 |
| unaffiliated_person
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Aug 18 2008 22:30:47
Cici wrote:
I don't believe that the general public knows this well kept secret ~ anyway the citizens of this great country don't know this well kept secret, but illegal aliens have only ONE Medicaid benefit. That is if they have an emergency which require hospitalization, life or death...then the bill is paid fully by WE the generous tax payers of America. Now, if I, a US Citizen had an accident and had to be admitted to the hospital in a life or death situation and had no insurance, guess who pays for that?? You're right ~ ME for the rest of my freakin life!! That is why so many illegals use the ER as a clinic!! WE THE PEOPLE need to get OUR act together and let the politicians know that they will not be voted for another term if they continue to esteem those that have come here illegally, over their own citizenry! It is pitiful!
I wouldn't call that a benefit, more like the feds trying to keep the hospitals afloat. Sadly, hospitals cannot bill them, so the government has to bail them out, leaving illegals with free medical care.
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#387934 |
| ThomasK
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Aug 18 2008 22:37:00
unaffiliated_person wrote:
Cici wrote:
I don't believe that the general public knows this well kept secret ~ anyway the citizens of this great country don't know this well kept secret, but illegal aliens have only ONE Medicaid benefit. That is if they have an emergency which require hospitalization, life or death...then the bill is paid fully by WE the generous tax payers of America. Now, if I, a US Citizen had an accident and had to be admitted to the hospital in a life or death situation and had no insurance, guess who pays for that?? You're right ~ ME for the rest of my freakin life!! That is why so many illegals use the ER as a clinic!! WE THE PEOPLE need to get OUR act together and let the politicians know that they will not be voted for another term if they continue to esteem those that have come here illegally, over their own citizenry! It is pitiful!
I wouldn't call that a benefit, more like the feds trying to keep the hospitals afloat. Sadly, hospitals cannot bill them, so the government has to bail them out, leaving illegals with free medical care.
Where does the government get their money?
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#387935 |
| joyce
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Aug 19 2008 02:39:54
There is another side to UVRMC not turning anyone away. The article made UVRMC sound so spiffy and wonderful.... like it were some kind of charity, but I think they and many other healthcare professionals are THE PROBLEM! The Sunday Aug 17th headliner about Utah healthcare funding for low income families similarly missed a key ingredient to affordable healthcare for everyone. That key is informed consent. In other words informing the consumer what the cost of care will be and even giving the consumer options for care.
20 yrs ago when I was a young mother I was so worried about a fever that my son had that I brought him to the ER in the middle of the night. Any nurse could have figured out he was just a little sick but no they had us poor uninsured college students unknowingly racking up a fine bill!
Several years later we still had no health insurance but had a child who had a smell coming out of her nose. I called various doctors offices and asked how much a visit with no tests would cost, but if needed how much tests could range etc. I finally decided to go to the office that gave me the clearest answer which was $35 if I didnt need any tests. The problem turned out to be a piece of plastic stuck up her nose. The doctor pulled it out easily in less than a minute. I went to pay and the bill was $50! How could the nurse have not known that for the doctor to actually DO something would cost $15 more?! The $35 was just to have him talk to us! It was very upsetting. However I paid and didnât say anything.
Not anymore!
I live very close to UVRMC so about a year later I went in a panic to the ER because my son had a big bike accident gash in his leg. I asked about the cost as usual and thankfully was told I would be better off to take him to a family doctor for stitches. I was glad for the reassurance! I did as suggested and we were very happy with the results. So that time they did right.
About a year ago a child of mine needed a wrist brace for a sprain. I was at a clinic in Orem. I said, "I think I could get it cheaper elsewhere."
The doctor said, âDonât worry. Your insurance will probably cover it. But we can get the price if you want.â
I said, "I would like that, Thank you."
The nurse came in, and I asked for the price as it didnât look like she was going to give it.
She said, "donât worry your insurance will cover it."
I said, âWell, I may be able to get it cheaper at Rite-Aid or something.â
"Oh, donât worry, she said, you can just take this one."
I finally conceded, but later my conscience got to me.
The next time I went to the drug store I saw the same kind of wrist brace sold for $15. I thought to myself they better not have charged my insurance company much more than that! I believe that when my insurance company pays more we all pay more. A bill eventually came from my insurance for ME to pay $69 of the $99 wrist brace!
That story had a happy ending though as I reported the clinic to my insurance company and CCd the clinic as well. The clinic kindly paid my balance of the bill and to my rejoicing, did a training for all their employees to be more sensitive to people who want prices.
Now you cant tell me, with the amount of time we spend waiting our turn in an ER, that a hospital cant even give a general estimate to most people! And if appropriate refer the person to a cheaper clinic (I polled the various emergency rooms 15 yrs ago after an expensive trip to the UVRMC ER and I discovered they were the most expensive.) Yet they didn't have the courtesy to tell us that even though our visit was obviously not life threatening.
I WILL DECIDE IF I WANT TO STAY AND ACCEPT MEDICAL TREATMENT OR NOT but its difficult when I am only given a ballpark estimate and ITS IMPOSSIBLE when Im REFUSED even that!
I think we should make it a law that hospitals and clinics HAVE TO give an estimate of cost, AT LEAST upon request!!!
Please tell your legislators about this idea if you agree. They need to know there are cheaper ways to help people afford healthcare than govât funded programs. I am going to send this letter to the non-profit health care advocacy group called Utah Health Policy Project, refered to in Sundays article too.
To find your legislator go to www.utah.gov and click on Government, then Legislative branch, and then Find my legislator. |
#387986 |
| KitKat
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Aug 19 2008 03:17:50
joyce wrote:
There is another side to UVRMC not turning anyone away. The article made UVRMC sound so spiffy and wonderful.... like it were some kind of charity, but I think they and many other healthcare professionals are THE PROBLEM! The Sunday Aug 17th headliner about Utah healthcare funding for low income families similarly missed a key ingredient to affordable healthcare for everyone. That key is informed consent. In other words informing the consumer what the cost of care will be and even giving the consumer options for care.
20 yrs ago when I was a young mother I was so worried about a fever that my son had that I brought him to the ER in the middle of the night. Any nurse could have figured out he was just a little sick but no they had us poor uninsured college students unknowingly racking up a fine bill!
Several years later we still had no health insurance but had a child who had a smell coming out of her nose. I called various doctors offices and asked how much a visit with no tests would cost, but if needed how much tests could range etc. I finally decided to go to the office that gave me the clearest answer which was $35 if I didnt need any tests. The problem turned out to be a piece of plastic stuck up her nose. The doctor pulled it out easily in less than a minute. I went to pay and the bill was $50! How could the nurse have not known that for the doctor to actually DO something would cost $15 more?! The $35 was just to have him talk to us! It was very upsetting. However I paid and didnât say anything.
Not anymore!
I live very close to UVRMC so about a year later I went in a panic to the ER because my son had a big bike accident gash in his leg. I asked about the cost as usual and thankfully was told I would be better off to take him to a family doctor for stitches. I was glad for the reassurance! I did as suggested and we were very happy with the results. So that time they did right.
About a year ago a child of mine needed a wrist brace for a sprain. I was at a clinic in Orem. I said, "I think I could get it cheaper elsewhere."
The doctor said, âDonât worry. Your insurance will probably cover it. But we can get the price if you want.â
I said, "I would like that, Thank you."
The nurse came in, and I asked for the price as it didnât look like she was going to give it.
She said, "donât worry your insurance will cover it."
I said, âWell, I may be able to get it cheaper at Rite-Aid or something.â
"Oh, donât worry, she said, you can just take this one."
I finally conceded, but later my conscience got to me.
The next time I went to the drug store I saw the same kind of wrist brace sold for $15. I thought to myself they better not have charged my insurance company much more than that! I believe that when my insurance company pays more we all pay more. A bill eventually came from my insurance for ME to pay $69 of the $99 wrist brace!
That story had a happy ending though as I reported the clinic to my insurance company and CCd the clinic as well. The clinic kindly paid my balance of the bill and to my rejoicing, did a training for all their employees to be more sensitive to people who want prices.
Now you cant tell me, with the amount of time we spend waiting our turn in an ER, that a hospital cant even give a general estimate to most people! And if appropriate refer the person to a cheaper clinic (I polled the various emergency rooms 15 yrs ago after an expensive trip to the UVRMC ER and I discovered they were the most expensive.) Yet they didn't have the courtesy to tell us that even though our visit was obviously not life threatening.
I WILL DECIDE IF I WANT TO STAY AND ACCEPT MEDICAL TREATMENT OR NOT but its difficult when I am only given a ballpark estimate and ITS IMPOSSIBLE when Im REFUSED even that!
I think we should make it a law that hospitals and clinics HAVE TO give an estimate of cost, AT LEAST upon request!!!
Please tell your legislators about this idea if you agree. They need to know there are cheaper ways to help people afford healthcare than govât funded programs. I am going to send this letter to the non-profit health care advocacy group called Utah Health Policy Project, refered to in Sundays article too.
To find your legislator go to www.utah.gov and click on Government, then Legislative branch, and then Find my legislator.
I have good insurance (fortunately) but still, I simply stay away from the ER unless it's a 'life or death' situation and I have only had two of those in 28 years. We use an Instant Care center where our co-pay is only $15.00. At the ER, we'd be paying far more. A couple years ago, my husband had a large burn on his inner thigh, 2nd and 3rd degree. The Instant Care center was even able to take care of that. The only times we've been to the ER was when my husband had a bleeding peptic ulcer that nearly killed him about 7 years ago and again last month when he had pnenumonia and was admitted to the hospital after emergency treatment.
For those who have no insurance, it's a whole other ball game and I do feel for them.
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#387989 |
There are too many comments to list them all here. See the forum for the full discussion.Discuss this article on the forums. (9 posts)
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