Facing scrutiny from their respective states, hospitals in both Utah and Minnesota last week promised to be kinder and gentler in their billing practices for uninsured patients.
Intermountain Health Care, Salt Lake City, pledged to sue fewer patients for unpaid medical bills and give greater access to providers outside its network as part of a continuing effort to quell criticism over its market dominance. And as Minnesota Attorney General Mike Hatch looked into hospital billing and collection in his state, four Minnesota health systems agreed to reform their debt-collection methods and voluntarily curb the prices they charge their uninsured hospital patients.
Intermountain, a 20-hospital system that dominates much of the Utah market, said it would cut interest rates on payment plans and promised not to take patients to court unless there is evidence of fraud or an unwillingness to pay. At the request of the medical community, Intermountain also agreed to offer a new PPO this year that would allow all qualified providers to participate and said it would stop leasing its physician network to other insurers next year.
The policy changes follow the passage of a bill in March that created a task force to study the effects of Intermountain on Utah's healthcare market. Intermountain, which operates 52% of Utah's acute-care beds, subsequently signed a memorandum of understanding to open its books, policies and practices to the task force.
The two-year Minnesota deal, announced May 5, follows an early April settlement between Hatch and a fifth Minnesota health system, seven-hospital Fairview Health Services, Minneapolis, in which Fairview agreed to give more patients discounts and allow outside oversight to ensure it curbs aggressive debt-collection policies.
Last week's deal involved Allina Hospitals and Clinics, Minneapolis; North Memorial Health Care, Robbinsdale; Park Nicollet Health Services, Minneapolis; and HealthEast Care System, St. Paul. The four Twin Cities health systems and Fairview represent roughly 50% of Minnesota's hospital admissions, Hatch said.
Allina, North Memorial, Park Nicollet and HealthEast agreed to charge hospital patients with a household income of less than $125,000 no more than the amount paid by the hospitals' largest insurer. Minnesota's deal affects 16 Minnesota hospitals and one Allina-owned hospital in Wisconsin, 27-bed River Falls (Wis.) Area Hospital. The discounts apply to uninsured hospital patients and patients with insurance who received care not included in their benefits.
The four systems also agreed to heightened standards for debt collection for hospital and clinic bills. Before filing a lawsuit to collect money, hospitals must ensure patients actually owe debt; insurers have been billed when possible; and patients unable to pay a bill all at once have been offered a payment plan or charity care. The hospitals also agreed to seek court approval before garnishing patients' bank accounts and pledged to develop a "zero tolerance" policy for abusive debt collection.
Hatch and Bruce Rueben, president of Minnesota's Hospital Association, praised the deal and expressed a desire to see other Minnesota hospitals adopt discounts and reforms. An estimated 400,000 Minnesotans lack insurance.
"We're doing what we can do," Rueben said, but hospitals alone cannot fix the much wider problem of access to affordable healthcare.