Hospitals in Missouri spent nearly 10% more on uncompensated care last year than they did in 1994, according to figures released last week by the Missouri Hospital Association.
The association released the figures in response to a MODERN HEALTHCARE* article that said the state's hospitals were spending less on care to the poor and not fulfilling a promise to develop a voluntary program to publicly disclose the benefits they provide to their communities (Nov. 11, p. 52).
At the time, the hospital association declined to release any information about the disclosure program, and the Missouri health department declined to release 1995 data on hospitals' uncompensated-care costs.
According to the MHA's figures, Missouri's 147 hospitals incurred $364.6 million in uncompensated-care costs last year, up 9.7% over 1994's costs of $332.1 million.
Uncompensated-care costs are the total of hospitals' charity-care and bad-debt expenses. The hospital association and state health department define uncompensated care in the same way, but their figures are slightly different.
However, both organizations detected a nearly 2% drop in hospitals' uncompensated-care spending in 1994.
The following year, the hospital association and the state health department agreed to devise a voluntary community benefits disclosure program as a compromise with the state Legislature, which had threatened to tie the tax exemptions of not-for-profit hospitals to levels of care for the poor.
In theory, the association and health department would combine their information into a single publicly available annual report on every hospital in the state. By having the information publicly available, the state hoped to create an incentive for hospitals to spend more on care for the poor.
But, as MODERN HEALTHCARE disclosed, the program has yet to get off the ground and more than one-third of the state's hospitals have not signed up for it.
But Barbara Long, the hospital association's spokeswoman, said progress is being made. She said association and health department staffers met last month to discuss the program, and those talks "are ongoing."
Long also said the association is now working on a format for the community benefits information to be released to the public on an annual basis. However, the two parties have yet to come up with a timetable for releasing the first reports to the public.
The threat of public disclosure isn't behind the surge in hospitals' uncompensated-care spending last year, according to the association. It attributes the big jump to changes in patients' insurance status. More people are losing their benefits, and others have medical problems that aren't covered under their benefits packages, Long said.
Although the hospital association's figures reveal an overall rise in hospital spending on the poor last year, they verified a trend picked up in the state health department's data showing for-profit hospitals are spending less on care for the indigent.
While spending on the poor jumped in both the private not-for-profit and public hospital sectors in Missouri last year, it continued to drop in the for-profit hospital sector.
The state's 10 for-profit hospitals spent $13.1 million on uncompensated care in 1995, down about 1.5% from 1994. That follows a nearly 4% drop in uncompensated-care spending a year earlier.