Indigent care demands jump

CNJ Staff Photo: Liliana Castillo Dr. Tracy Arghavani reviews patient charts between appointments at a nurse’s station of La Casa Family Health Center in Portales.

By Liliana Castillo: CNJ Staff Writer

Demand for indigent care has jumped almost 40 percent at one local hospital and increased four-fold at area clinics for the poor and under-insured.

Administrators at Plains Regional Medical Center and La Casa Family Health Centers in Clovis and Portales say they believe the reason for such huge increases in indigent patients is the economy.

Plains Regional Medical Center administrator Hoyt Skabelund said the clearest sign the economy is in trouble is an almost 40% rise in indigent care the hospital provides. He said the whopping increase in indigent costs has happened even while the hospital’s patient count has remained about the same.

“In 2007, we provided five million dollars in indigent care. We finished with 6.9 million in 2008,” he said.

Skabelund said that the rise in charity care is caused by several factors — one being patients are either under-insured or they simply do not have the money for routine health care.

“A much higher percentage of our patients are now below a certain poverty level,” Skabelund said. “And people who can afford health care are not seeking to take care of health issues.”

Though charity care and “bad debt” bills the hospital counts as unpayable are on the rise, Skabelund said the hospital is still managing to do well financially because of cost-cutting measures taken two years ago.

“We are always looking at how we can match our expenses to our revenue,” Skabelund said. “Two years ago we made great efforts to reduce our costs in case we saw ourselves in a difficult situation. That was effective and we’re grateful for that. We find ourselves in a good position today because of it.”

The hospital cut 40 positions in 2006, saving approximately $2.4 million in salaries and benefits.

La Casa Chief Executive Officer Serefino Montano said he recalled a month late last year when the clinics registered 400 new users. That’s about four times the 60-100 new users in a regular month.

“Some of our new patients don’t have health coverage, whether they’ve lost their job or are trying to save money,” said Montano. “Some don’t make appointments for routine check-ups because of their fear of the weakening economy.”

Montano said the economy is affecting La Casa in several areas, including insurance companies looking over paperwork more thoroughly before providing reimbursements.

“They’re trying to save what they can for their company, but it causes problems for patients and providers,” he said. “It is a trying time for all of us in health care.”

Though the clinics are wary of the financial future, Montano said the focus continues to be on patients.

“We went through a period about a year ago where we lost a lot of our providers. In the past year and a half, I’ve recruited 12 new providers and there’s a large cost associated with that,” Montano said. “But it’s good for our community and its members to have more access to health care.”

“Despite the economy, we are placing an emphasis on outreach. We want to let the community know that if you don’t have money, come in anyway. We don’t want to jeopardize health care. We’re going to take care of you whether you have the money or not,” Montano said.

Montano said LaCasa’s board of directors has instructed him to look for places to make adjustments. But making staff changes is the last thing the clinic intends to do, he said.

“There are reports of unemployment rates going up all over the country,” said Montano. “We don’t want the people in our community to lose their jobs.”