Back in May, University of New Mexico Hospital officials had good reasons to start enforcing a 2015 requirement that uninsured patients pay 50 percent in advance for “non-emergency” surgeries. First, when uninsured patients don’t pay, the hospital and taxpayers are stuck with the bill. And second, when the hospital finds out at the 11th hour a patient has not paid the required share for their scheduled surgery, the cancellation leaves a valuable medical staff staring at an expensive and unused operating room while other patients in need wait for a spot to open on the schedule.
Why it took UNMH two years to enforce its rule, then address the unintended consequences, is a good question.
But enforce it the hospital finally did, and advocates for those patients who were affected in turn had good reason to object to the 50 percent provision: Many low-income patients simply could not scrape up half the cost in advance and the new enforcement had the effect of barring some from getting much-needed – but not “emergency” – surgeries, including knee replacements, hysterectomies and hernia repairs.
And while thousands did get care – in the past year, UNMH has treated 12,141 low-income patients in the “50 percent-up-front” category, patients who qualify for a 45 percent discount for surgical procedures and are primarily undocumented immigrants who lack insurance or Medicaid and don’t qualify for UNMH financial assistance – UNMH officials recognized not all could. They have now come up with a compromise that should help those patients while protecting taxpayers.
The revised patient payment policy says discount-eligible uninsured and indigent patients can have non-emergency surgeries after paying a co-pay of between $25 and $300 based on their assets and income level, and agreeing to a payment plan for the balance of their medical costs.
(It bears repeating that emergency and “medically urgent” surgeries, as always, continue to be done regardless of a patient’s ability to pay and all non-emergency surgical patients have to go through the same financial consultant process.)
When UNMH started enforcing its policy, the Journal said everyone should be required to pay as much of their medical bills as possible. Now, by determining each patient’s ability to pay for their care – and setting up a reasonable payment plan to ensure they do – UNMH has struck a healthy fiscal balance that makes better sense for low-income patients while protecting the bottom lines of the hospital and taxpayers.
This editorial first appeared in the Albuquerque Journal. It was written by members of the editorial board and is unsigned as it represents the opinion of the newspaper rather than the writers.