The Denver Health Medical Center chief says the hospital is considering reducing care for uninsured patients if rising costs continue to outpace government subsidies.
The pace of financial losses has slowed, said Dr. Patricia Gabow, the hospital's chief executive office. Denver Health lost just $93,000 in the first three months of this year, compared with $5.4 million in the first four months of 2003.
But Gabow said the cost of caring for the uninsured rose to $240 million last year and prescription costs are skyrocketing. The cost of charity care has risen $87 million in three years, but the revenue to support it has risen just $14 million.
"We either need new revenues or a decrease in the uninsured, or we are going to have to make some tough decisions," Gabow said.
Denver Health, the state's largest provider of medical care for the poor, is considering such options as eliminating elective surgery for uninsured patients, limiting appointments for the poor and increasing co-payments for drugs and other services.
Gabow said she wants to avoid other choices, such as eliminating the services that lose the most money but still are essential, such as mental health, specialty care and dental services; or simply no longer accepting new uninsured patients.
Denver Health has put together a team from health care and industry to overhaul the system, which Gabow hopes can save $40 million a year.
If Denver Health joins University of Colorado Hospital in limiting services to the uninsured, care for non-life-threatening injuries may become more difficult to obtain, said Catherine Montoya, public policy director for the Colorado Consumer Health Initiative, a nonprofit patients' rights group.
"We should wait until we're on death's door?" Montoya asked. "Sooner or later, we are going to reach the point where someone who is uninsured is not going to be."