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Show Hingkley Journal of Politics 2005 Department of Health and Human Services 2003, 28). HAP negotiates with medical providers and facilities in the community to donate services to uninsured individuals who are ineligible for all federal and state programs, and for services not provided to enrollees of the PCN. In some regards, the HAP fills in some of the requirement gap of 501(c)(3) hospitals to provide charity care. Utah's Hospital System A number of Utah hospitals receive federal tax exemption status, 501(c)(3). In addition, they receive a significant portion of their funding from government programs like Medicaid and Medicare. How much free care do these hospitals provide? Do tax-exempt, not-for-profit (NFP) hospitals in Utah provide more charitable services than Utah's for-profit hospitals? In order to determine the hospital practices and Procedures, and charity programs available to Utah's uninsured, seven interviews were conducted with different hospitals in various parts of Utah. Methods •^ purposive, nonprobability sample was conducted from a sampling frame that was reviewed and narrowed from 95 list-lngs to 64 to represent only hospitals, medical centers, and surgical centers in Utah. The sampling frame, which includ-ed a list of billing departments of various Utah hospitals, deluding some billing departments for the Mountain West Region outside of Utah, was provided for the purpose of retrieving billing information for medical claims. The sample Population was drawn from among the 64 hospitals in the study population, which was narrowed to 12 hospitals through a judgmental selection to achieve a sample population representative of the total study population. Although one sample bias was eliminated by extending the sampling frame beyond the members of the Utah Hospitals and Health Systems Association, which includes °nly 42 of Utah's hospitals and medical centers (Utah Hospitals and Health Systems Association 2005), another sampling bias may have occurred within the method of selection. Of the 12 hospitals in the sample population, seven responded to the survey interview questions. For purposes of the study, a single-blind idiographic telephone survey was conducted, with the identity of the researcher remaining anonymous to the respondent. Among the seven hospitals that responded, four were NFP and three were for-profit hospitals. Three of the hospitals were from the same NFP hospital chain. Two hospitals were unclassified, one was from a chain of for-profit hospitals, and one hospital was a teaching hospital. The seven hospitals that responded represented three regions of Utah: rural areas; middle-class income and homogenous suburban regions; and low-income and densely-Populated urban regions of Utah. The results are shown in Figure 1. The idiographic survey questions were developed with assistance from the Community Catalyst report (2003), and Figure 1. Hospital Response Rate By Tax Status and Region ? Not-for-profit ¦ For-profit a Government-owned from the article "Hospital Charity Care/Nonprofit Status: Internal Revenue Service Issues Guidance on Nonprofit Hospitals' Charity Care Obligations," also published by Community Catalyst. The survey instrument included the following questions: Hospital Study Survey Instrument Does the respondent's hospital/institution: 1. Provide free care if someone's income is limited? 2. Provide reduced-care if someone's income is limited?, 3. Have a charity or free care policy? 4. Provide financial assistance, such as payment plans? 5. Employ a financial counselor to work with an individual's financial situation? 6. Provide care to an individual regardless of proof-of-payment in an emergency situation? 7. Require a deposit to provide care? 8. Require an application or other paperwork to receive care? 9. At what point does the paperwork need to be completed before services are rendered? 10. Have a written free care/charity care policy you can mail, fax, or email me, or one that I may pick up? 11. What services are covered under the charity care program Results The results of the surveys varied from hospital to hospital, regardless of the hospital chain and tax status of each hospital. In addition, contact with five additional Utah hospitals was attempted, but phone calls were not returned. Three of the five hospitals were NFP from the same hospital chain, while the other two hospitals were for-profit facilities, from different hospital chains. Figures 2, 3, and 4 describe the responses to the survey instrument. The question responses correspond to the question numbers in the survey listed above. Figure 2. Responses to Free Care or Chanty Care By Hospital Tax-status RESPONSES TO QUESTIONS 1,2, & 29 |
