Medical University of South Carolina, which now treats everyone regardless of whether they can pay the bill, wants hospitals across the state to help care for more indigent patients as the school tightens its budget.
"As the numbers of uninsured and underinsured patients have grown in South Carolina, our primary-care programs are being strained beyond their capacity," Layton McCurdy, M.D., vice president of medical affairs and dean at the Charleston-based medical college, wrote to every licensed doctor in South Carolina late last month.
"As a result, we are carefully examining our ability to provide quality medical care in our teaching panels to an unlimited number of people," McCurdy wrote.
McCurdy said more than 15% of South Carolinians do not have health insurance. The university and its not-for-profit physicians group, University Medical Associates, expects to provide $72 million worth of free care this fiscal year.
The university likely will discourage "unnecessary referrals" from out-of-town doctors for patients who could receive the care in their hometowns, McCurdy said. It's common for doctors to send an uninsured person with a broken arm 110 miles to the university for care, and "that doesn't make sense," he said.
MUSC expects a budget shortfall this fiscal year. Through the first six months ended last December, Charleston Memorial Hospital, one of the university's treatment centers, was more than $4 million in the red.
In the 1980s, the university had similar money problems. "It is cyclical," McCurdy said. "And that gives us the strength to go on."
University officials estimate the Balanced Budget Act of 1997 and its reductions in Medicare and Medicaid will cost the school $28 million.