Cost Cuts to Reach More Patients

Responding to a growing number of people without health insurance, Ventura County is expanding steeply discounted rates at its only public hospital to make it more affordable to working families.

Discounts in the past typically have targeted patients who were near poverty but did not qualify for Medi-Cal or Medicare, officials said. But with health coverage premiums soaring, beds at Ventura County Medical Center increasingly are being filled by low-wage earners with no insurance, hospital administrator Michael Powers said.

Under the plan, rates are tiered by income and family size. Patients with household incomes near $30,000 qualify for a 75% discount or a charge equal to 50% of Medicare rates, whichever is lower.

But the working poor are not the only ones eligible for a discount. Families with a $75,000 income qualify for a 25% discount or a payment equal to 80% of Medicare rates.

Obstetrical care, including deliveries, is excluded from the county’s discount policy. But the hospital will offer OB care packages at rates comparable with other hospitals.

County supervisors unanimously adopted the plan at their Tuesday meeting and praised Powers for bringing it to them.

Although the economy is recovering, most new jobs are low-paying and often don’t include health coverage, board Chairman Steve Bennett said.

“Our safety net has to become more and more proactive about how to provide these services and still recover our costs,” Bennett said.

A study by the Kaiser Commission on Medicaid and the Uninsured released in December showed that the number of uninsured people increased 10% in two years, to 43 million Americans.

The uninsured come primarily from working families with low and moderate incomes for whom coverage is not affordable, the study reported.

Nearly two-thirds had incomes of $28,700 or less for a family of three, the report said. But 35% came from wealthier households, reporting up to $43,000 in annual wages.

The trends are the same in Ventura County, Powers said.

Nearly all hospitals in California arrange payment schedules for the uninsured, said Jim Lott, spokesman for the Southern California Hospital Assn.

But Ventura County’s plan takes it a step further by discounting rates at the outset, and offering the reduced prices to a wider range of income levels, he said.

“It’s a progressive idea. It’s likely to be somewhat precedent-setting,” Lott said.

“It is a positive move for consumers, especially self-pay consumers.”