Portland Service Area

Hospital

Financial Assistance Guidelines

 

A Well-Considered Response to Community Health Need

 

 

Prepared by:

Oregon Health Action Campaign

Submitted to:

Tri-County Communities in Charge

Multnomah County Health Department

1120 SW 5^th, 14^th floor, Portland, OR  97204

(503) 988-3674

 

DRAFT:  02-15-02

 

 

Table of Contents:

Executive Summary	iii
Acknowledgements	iv
Financial Assistance Agreement – Portland Service Area Hospitals.  (Note:  In a March 15th, 2001 letter, the Oregon Association of Hospitals and Health Systems – OAHHS - encouraged its affiliated hospitals to “seriously consider” implementing the uniform financial assistance policies and procedures developed by the Portland are hospitals in a process facilitated by OAHHS).	v
Chronology of Events	vi
Community Benefits:  Need and Historical Context	1
Evaluating the availability of charity care information:  Community Based Research Research Methodology Summary of Findings Implications of findings	2
Next Steps	4
Appendix 1.  OHAC Director's Statement	6
2.  Portland Service Area Hospital Financial Assistance Task Force Report	7
3.  Safety Net Application	25
4.  Press Coverage (inserts)	26
5.  Financial Assistance Brochure (inserts)	27

 

 

EXECUTIVE SUMMARY

In November 2000, after several months of meetings, in a process facilitated by Oregon Association of Hospitals and Health Systems (OAHHS) Portland Service Area Hospitals completed the development of uniform financial assistance policies and procedures.  Key components of their agreement included:

§         100% assistance for families at or below 150% Federal Poverty Level.  Partial assistance for families between 150-200% of FPL.  Case-by-case consideration of assistance for families above 200% FPG.

§         Financial application and materials written in at least four most frequently used languages at grade school reading level.

§         Published communications such as signs, business cards, in key access points specifically: emergency rooms, admitting, business/ patient account offices, urgent care centers.  Notification of assistance on every bill sent to patients (when technically possible).

§         Brochure available to public that explains the Financial Assistance process in user-friendly terminology.  Information about assistance available during registration process.  If a person's situation changes, they can reapply for assistance.

§         Standardized application process in Portland area.

 In March 2001, the Oregon Association of Hospitals and Health Systems encouraged all of its affiliates to seriously consider adopting the policies and procedures developed during the Portland area process.  Several had already done so.[1]

Portland area hospital financial assistance policies and procedures have been in place for one year.  Throughout the year, representatives of Portland’s health safety net, the Oregon Health Action Campaign, Tri County Communities in Charge and the Portland service area hospitals have continued to meet to discuss successes, challenges, and components of an evaluation of financial assistance policy implementation.

This document describes the chronology of events leading up to the Portland area agreement; the historical and legal framework for provision of charity care / community benefits; components of the consumer research that highlighted the problems with patient access to information about charity care / financial assistance; and steps that must still be taken to ensure that all those eligible can learn about and take advantage of the opportunity to apply for financial assistance.

It has been compiled in hopes that it may provide guidance to other health institutions and health advocacy organizations struggling with ways to provide universal and affordable access to some level of health services in the long dawning of the systemic and policy reform necessary to bring about universal coverage.

Acknowledgements

Our work and success would not have been possible without the financial and / or personal / professional support from the following organizations and individuals:

Coalition of Community Health Clinics

Community Catalyst

Kaiser Permanente

Legacy Health System

Multnomah County Health Department

Neighborhood Health Clinics

Oregon Association of Hospitals and Health Systems

Oregon Health Action Campaign

Oregon Primary Care Association

Providence Health System

Salem Hospital

Tri County Communities in Charge

Wallace Medical Concern

Northwest Health Foundation

Public Welfare Foundation

Robert Wood Johnson Foundation

Surdna

Kent Ballentyne

Ric Burger

John Lee

Dennis Noonan

Colleen Russell

Ken Rutledge

Terry Smith

Michael Sorensen

Teresa Spalding

Barney Speight

Steve Weiss

 

About the key participating organizations

 

Coalition of Community Health Clinics:  A network of private, non-profit community clinics in the Portland Metropolitan area that provide primary health care services to people who have no access to mainstream healthcare.  Clinics represent a large portion of the urban “safety net”, assuring quality primary health care services to those unable to receive them in traditional medical settings.

 

Oregon Association of Hospitals and Health Systems

OAHHS MISSION

Oregon Association of Hospitals and Health Systems is a statewide association

dedicated to providing representation, advocacy and assistance for hospitals

and healthcare systems. The association, through leadership and collaboration

among healthcare providers, promotes quality healthcare that is adequately

financed and universally accessible.

 

 

 

Oregon Health Action Campaign (OHAC):  a coalition of individuals and organizations committed to empowering the consumer voice in the development of health systems that give all people access to the care they need, when they need it, from providers of their choice at an affordable cost.  OHAC houses the Mergers, Acquisitions and Community Benefits Taskforces, and the Portland and Marion/Polk County Community Benefits Taskforces.

 

 

Tri-County Communities in Charge

 

The Tri-County Communities in Charge (TCCIC)  initiative is a local initiative with focus on health care access for all within the Portland Metropolitan region. This initiative has built on a community consensus around two themes that serve as the foundation for the community's approach to care for the uninsured. The two themes are:

1.      Refine and restructure the safety net system to utilize existing resources with greater efficiency and effectiveness; and

2.      Increase access for defined populations and sub-populations through well-planned investment of resources for system expansion.

The Tri-County Communities in Charge initiative emphasizes a process that will develop the existing health care safety net into a well functioning and integrated system of care for the uninsured. The three major components employed to accomplish these tasks include:

• A Safety Net Authority to organize and govern the safety net system.
• An Outreach and Education Program to promote of the safety net and other resources
• A Uniform Charity Care Policy to be implemented by local hospitals

 

 

 

Chronology of Events

1994 – 1998:  Numbers of people call Oregon Health Action Campaign (OHAC) offices to ask for help in paying past due hospital bills or describing being sent to collections by hospitals.

Spring and summer 1999:  OHAC recruits, trains and dispatches volunteers to research the availability of charity care policies and interpretation services in Marion and Polk County hospitals.  Bankruptcy records and lien filings also researched.

December 1999:  OHAC meets with Salem Hospital to discuss results of research and resulting report to be released by end of January, 2000.  Meeting participants include people who have been sent to collections or been forced into bankruptcy by hospital collection practices; the CEO, CFO and various staff from Salem Hospital; and representatives from OHAC and Salem area ecumenical, labor and elder organizations.

Mid – December 1999:  Dennis Noonan, CEO Salem Hospital, convenes meeting which includes representatives of the three other Marion Polk County Hospitals and the same people who were part of the first December meeting.

January 2000:  Marion and Polk county hospitals agree to adopt and implement uniform charity care policies and procedures and to participate in March, 2000 community forum on unmet health need.

February 2^nd, 2000:  Meetings with the press, Marion and Polk County hospitals and OHAC to present financial assistance procedures and report that triggered their development.

February and March 2000:  Research process initiated and completed in Portland metropolitan area.

July 2000:  OHAC’s Ellen Pinney invited to OAHHS Board of Trustee meeting to discuss need for accessible charity care policies and procedures.

Summer 2000:  Community Benefits Taskforce members meet with John Lee, Providence CEO and Terry Smith, Providence CFO to discuss results of Portland area charity care research.

September 12, 2000:  Providence hosts meeting between all Portland area hospitals and OHAC to discuss results of OHAC research and recommendations.

September – December 2000:  Portland area hospitals continue meetings to develop proposal for uniform financial assistance policies and procedures.

June 2001:  Press conference with OAHHS, Portland hospitals and OHAC to announce uniform financial assistance policies and procedures.

March 2001 – January 2002:  Periodic meetings between members of the Coalition of Community Health Clinics and accounts receivable staff of Portland area hospitals to discuss successes and challenges of single safety net application for hospital financial assistance.

June 2002:  Meeting scheduled between Portland area Community Benefits Taskforce and Portland area Hospitals to discuss results of second round of grassroots research on accessibility of financial assistance policies and procedures.

 

 

 

 

 

 

 

FINANCIAL ASSISTANCE POLICIES AND PROCEDURES

BEST PRACTICES AGREEMENT

PORTLAND SERVICE AREA HOSPITALS
November 2000

Income Guidelines:

·          100% assistance for families at or below 150% FPG.

·          Partial assistance for families between 150-200% of FPG.

·          Case-by-case consideration for assistance for families above 200% FPG.

·          Every step taken to assure a family does not declare bankruptcy from medical bills.

·          Asset verification may include liquid and non-liquid assets dependent upon situation.

Cultural Accessibility:

·          Financial application and materials written at grade school reading level.

·          Materials in four most frequently used languages for demographic area.

·          Other language interpretation available as needed.

·          Published communications such as signs, business cards, in access points of care, specifically: ED, BO, admitting, urgent care centers.

Public and Employee Awareness:

·          Hospital staff knows how to refer a person for assistance.

·          Notification of assistance on every bill sent to patients (when technically possible).

·          Brochure available to public that explains the Financial Assistance process in user-friendly terminology.

·          Information available during registration process about assistance programs.

User Friendly Process:

·          Help in completing financial qualification process.

·          Help with completing Oregon Health Plan application process.

·          Coordination with safety net clinics (generic Assistance Applications on hand the hospitals will accept).

·          Standardize application process in Portland area.

·          Same application process regardless of amount owed.

Collection Process:

·          No interest or late penalties for families with incomes below 200% FPG.

·          Review any situations where family states medical bills will cause bankruptcy.

·          Accounts will not be assigned to a collection agency during the Assistance process.

·          Appeal process that's communicated to all patients who apply for assistance.

·          If a person's situation changes, they can reapply for assistance.

 

 

 

 

Community Benefits:  Need and Historical Context

Millions of Americans lack access to health coverage either because their employer does not offer it or they cannot afford to pay for it. Although Medicaid covers millions of low-income people, 44 million Americans are not eligible and, therefore, uninsured. Oregon is no exception. During the 1990s, Oregon's population grew at a rate twice the national average.  As the number of Oregonians increase, the numbers of residents who are uninsured increase. Despite the implementation of the state Medicaid program, the Oregon Health Plan, the uninsured population increased from 340,000 to 420,000 (from 10.6 percent to 11.2 percent of the state's population) between 1997 and 2000.

The majority of people without health insurance in Oregon work at incomes less than 200% federal poverty level for employers who do not provide health coverage.  They  must choose between putting food on the table, paying for rent, utilities and childcare, and paying for necessary health care.  They are 55% more likely to postpone care; 4.7 times less likely to obtain prescription drugs; and four times more likely to use the emergency rooms for non-urgent care needs.

In order to receive medical services, the uninsured rely on community health clinics, county health departments, and non-profit hospitals.   Access to hospital emergency rooms is the only access for the uninsured in many parts of the state.  Safety net clinics provide access in the Portland metropolitan area and in Marion and Polk counties.  In addition in the Portland Metro area, the County Health Department acts as a safety net, providing primary care services.

 Over 85% of acute care hospitals in Oregon are non-profit or publicly owned, while four are investor-owned. Non-profit hospitals are owned and operated for the benefit of local residents under the leadership of a volunteer board of directors. Non-profit hospitals in the United States have been exempt from taxation since 1751 when Benjamin Franklin established the Pennsylvania Hospital. They are exempt from federal and state income taxation as 501(c)(3) organizations, and from local property taxes under ORS 307.130. In lieu of taxes, non-profit hospitals provide community benefits:  un-reimbursed health-related services that address a community’s unmet health needs

Charity care is a critical community benefit provided by hospitals in exchange for their tax-exempt status. Charity care is free or discounted services provided by a hospital for people who demonstrate they cannot afford to pay for care. Hospitals do not expect to receive payment for charity care services.

Despite the critical role charity care plays, the uninsured are seldom aware of such assistance. Nationally, medical bills accounted for forty-five percent of personal bankruptcy filings in 1999. A recent study shows that of the estimated 64,000 uninsured living in Multnomah County (in which Portland resides), 20% have filed for bankruptcy because of medical bills; 25% are currently paying off medical bills; and 20% are in collections as a result of medical bill. Evidently, the uninsured, both nationally and in Portland, are not receiving adequate information and instructions to access financial assistance for hospital services. Many who have experienced financial hardship because of medical bills in Oregon should have qualified for free or reduced-cost care under existing but unadvertised charity care policies.

 

Evaluating the availability of charity care information

To better understand non-profit hospitals and the vital provision of community benefit - charity care - Oregon Health Action Campaign’s (OHAC) Community Benefits Task Force monitored the accessibility of hospital charity care policies in three communities:  Marion and Polk; Portland metropolitan and Lincoln County.  This report highlights the Portland are work.

Methodology

The charity care-monitoring project conducted by the Oregon Health Action Campaign (OHAC) was designed to engage community leaders in assessing the ability and willingness of non-profit hospitals to communicate with uninsured representatives seeking information about financial assistance. From the perspective of the community and potential users of financial assistance, OHAC aimed to explore and document:

·         whether a hospital has a written formal charity care policy;

·         how easy or difficult is it to find out about the charity care policy;

·         what steps the hospital takes to inform people about free or discounted care; and

·         what the process of obtaining free or discounted care is like.

Data was gathered over a two-week period in February and March 2000. Phone and site surveys were conducted with six Portland hospitals -- Providence, Emanuel, Tuality, OHSU, Portland Adventist, and Good Sam.

Twelve volunteer community agency representatives, uninsured individuals, and activists participated in a three-hour training that instructed volunteers on how to seek and document information about the charity care policies of each selected hospital. Each volunteer was provided with a written script to guide him or her through the charity care monitoring process

Uninsured callers telephoned general hospital numbers and sought information about charity care policies. Each volunteer phoned a minimum of three different hospitals at three different times; two times during business hours and one time during weekend hours. Each of the volunteer callers dialed a hospital’s general telephone number and asked if charity care is available when someone’s income is limited.  Calls were made by English and Spanish speakers.

Other volunteer researchers who represented Portland's uninsured walked-in/rolled-in to hospital emergency departments as well as reception and intake areas. The volunteers documented any signs about charity care or payment policies and sought free care policy information on site in emergency departments.

Finally, staff from community based organizations sought information on charity care for their clients and potential clients needing health services by telephoning each hospital’s financial department.  In total, each hospital was contacted 6 times

Summary of Findings

Most hospital employees, had little or no knowledge of Portland hospitals’ charity care policies. In all instances, hospital staff stated that “no one will be turned away due to an inability to pay”. Unfortunately, they rarely knew if financial assistance existed or how to access such information. Only three times out of  a total of 36 contacts did a volunteer access a financial assistance application. A charity care policy was obtained only once.

Highlights of the findings indicate:

·         Community agency representatives and the uninsured had little access to non-profit hospitals’ charity care policies.

·         Employees knew that their emergency department does not refuse services regardless of a patient’s ability to pay. Employees rarely knew, however, about cost or billing procedures for services received in emergency rooms.

·         Awareness and understanding of charity care policies varied greatly from employee to employee. Most hospital employees had little to no knowledge of their employer’s charity care policies.

·         Charity care was rarely mentioned unless the caller specifically broached the topic. Even after directly asking about charity care, most hospital employees were unfamiliar with the policy.

·         Availability of information on financial assistance varied greatly among individual employees and depended on the assertiveness of the volunteer researcher.

·         Several hospitals’ employees were vaguely aware of a sliding fee scale within their systems.

·         Hospital employees had an awareness and understanding of the Oregon Health Plan.

·         Oregon Health Plan (OHP) posters or brochures were often available in emergency departments as well as reception and intake areas. Information on OHP was available in Spanish and English only.

·         Monolingual Spanish speaking persons were unable to access any information (either written or verbal) pertaining to charity care from any of the approached Portland hospitals.

·         Community based agency staff were always declined access to the hospitals’ charity care policies. Community based employees were told by several of the hospitals that they would send them a copy of the policy and yet copies were never received.

Implications

Community benefits provided by a non-profit hospital address a community’s unmet health needs and are developed, prioritized, and implemented in an open community-based process. According to U.S. history and law, non-profit hospitals are owned and operated for the benefit of local residents. Charity care is a critical community benefit provided by hospitals in exchange for their tax-exempt status.

Charity care is one of the few sources of affordable care for the uninsured. It is vital for hospitals to effectively communicate their charity care policies to the public. When non-profit hospitals fail to adequately inform the uninsured about their financial assistance opportunities, they prevent access to health care. This study showed that while each Portland Metropolitan hospital has free or reduced-care, the policies and procedures of charity care are inconsistent and frequently unknown by hospital employees.

As a result of this research and other projects addressing community benefits around the United States, OHAC’s Portland Community Benefits Task Force developed “Best Practices of Charity Care.[2]”

Next Steps

§         Portland area hospitals have collaborated with the Coalition of Community Health Clinics, Tri County Communities in Charge and OHAC to put together a financial assistance manual for clinic, county, patient accounts, and outreach workers working to help people apply for financial assistance and/or the OHP.  The book describes services covered by each hospital under the financial assistance agreement and who to call with application problems or questions.  It includes the brochures and business cards used by each hospital.

§         A simple, 5^th grade language brochure is being developed for distribution to the public at large.  The brochure starts with the simple question:  “Do you need help paying your hospital bill?”; describes the help that is available and how to apply.

§         Nurture the community awareness and relationships necessary to encourage hospitals in additional, targeted Oregon communities to adopt financial assistance policies and procedures recommended by OAHHS.

§         Work with all hospitals in areas that have adopted financial assistance policies and procedures to coordinate outreach and application assistance for the Oregon Health Plan.

§         Collaborate with all hospitals in areas that have adopted uniform financial assistance policies and procedures to develop a process that engages the medically vulnerable or organizations that represent them in identifying and prioritizing community benefits responsive to community health need.

§         Evaluation of results of the implementation of financial assistance policies and procedures, particularly the safety net/hospital collaboration.  Evaluation components to include, at a minimum:  Numbers of referrals for charity care approved/denied; reasons for denial;  Average turn around time for decision;  total dollar amount requested;  total dollar amount approved.

 

 

 

 

 

APPENDIX 1

Statement of Ellen Pinney, Executive Director

Oregon Health Action Campaign

06-12-01

Oregon Hospital Financial Assistance Guidelines;
A Well-Considered Response to Community Health Need

 

Uniform hospital financial assistance policies and procedures were not developed or put in place over the course days, weeks or even months.  They were developed in response to real and researched community need.  They were developed thanks to the leadership, foresight, creativity and dedication of some brave and innovative hospital administrators and community members.  The collaboration that forged these guidelines was not always easy or smooth for everyone involved.  But all of us chose to put our differences to the side and focus on the result.  I believe I speak for everyone here when I say that we have a product we can be proud of.

In the Portland metropolitan, Marion-Polk and Lincoln County areas, we stand at the beginning of a new day for people whose outstanding medical bills and fear of incurring additional debt keep them out of the health system or force them into collections or bankruptcy.

My job is to provide background and context.

The Oregon Health Action Campaign (OHAC) is a coalition of individuals and organizations committed to empowering the consumer voice in the development of health systems that give all people access to the care they need, when they need it from providers of their choice at an affordable cost.

Over the years, OHAC has received an increasing number of calls from people who are unable to pay medical bills and feel threatened by potential or actual collection action.  The stories some of them are willing to share reveal that when people are struggling to pay medical bills or are forced into collections or bankruptcy because of unpaid medical bills, they are reluctant to return to the health system in any way.  They do not enroll in the Oregon Health Plan.  they delay treatment for health conditions that can worsen and will cost much more to treat if and when an emergency room visit becomes essential.

The stories OHAC has heard are substantiated by facts:

1.         Research in the Portland area revealed that 20% of the uninsured were paying off hospital bills; 25% were in collections because of medical bills; and 20% had filed bankruptcy because of medical bills (June 28^th, Communities in Charge Forum, Multnomah County Health Department).

2.         45% of all non-business bankruptcies filed in the United States were precipitated at least in part by the financial consequences of medical problems.  (Norton's Bankruptcy Advisor, May 2000).

3.         The more formal research OHAC did in the Portland and Salem areas showed that while all hospitals and all staff in the hospitals we surveyed consistently and clearly stated to all who asked that no one would be turned away because of inability to pay, information about the availability of charity care or financial assistance policies was close to impossible to get.  In all but four or five instances (out of more than 100) were any of our researchers given either policies, applications or information about the availability of charity care or financial assistance policies.

When OHAC presented its findings to Dennis Noonan, Salem Hospital CEO, in the latter part of 1999, he wasted no time in convening all four hospitals in the Marion/Polk County area to discuss how best to respond.  Their proposal and subsequent agreement, announced in March of 2000, was bold and unprecedented.  It reflected collaboration across unaffiliated hospital systems and informed responsiveness to community need.  It established the standard for future discussions.

Similar community-run research in the Portland area provided the impetus for the Portland area hospitals to come together.  The thoughtful and deliberate process chaired by Terry Smith, Providence CFO, resulted in the recommendations you have before you today.  These recommendations have been accepted and are being implemented by all Portland area hospitals and by two hospitals in Lincoln County.  The work, done in the private sector and out of the heat of legislative wrangling, proves again that Oregon is a national leader in innovative and collaborative approaches to addressing the needs of those currently underserved by our health system.  We believe this voluntary agreement sets a national precedent.

As is too well known, agreement on policy is just the first part of the effort.  The hard work is yet to come: implementation, evaluation, fine-tuning, and public outreach.  Most significantly, OHAC views charity care / financial assistance as only one vital and substantive component of a much larger obligation that all non-profits have to fulfill a charitable mission.  We look forward to our continuing work with Oregon hospitals to engage community members in the process of prioritizing, recommending and evaluating community benefits provided in response to unmet health need.

The work the Oregon Health Action Campaign has done over the years to research and develop community benefits organizing models in Marion/Polk, Lincoln and the Portland Metropolitan areas could not have happened without the support and dedication of many organizations and individuals.  I want to pay special tribute to Community Catalyst, The Access Project, Multnomah County's Communities in Charge, Surdna and the Northwest Health Foundation.  This document is a testament to the process employed in the Portland Area.

 

 

 

 

APPENDIX 2

 

Portland Service Area

Hospital Financial Assistance

Best Practices

December 2000

 

 

 

 

Co-Sponsors:

Oregon Association of Hospitals and Health Systems

Oregon Health Action Campaign

 

 

 

 

 

 

 

 

Purpose Statement

 

 

 

Portland Service Area Hospitals

Financial Assistance / Charity Task Force

December 2000

 

 

Agree to a common process that ensures Portland Area Hospitals meet their community obligations to provide financial assistance in a fair, consistent, and objective manner.

 

 

Participating Groups:

Adventist Health NW Network

Coalition of Community Health Clinics

Kaiser Permanente

Legacy Health System

Multnomah County

Native American Rehabilitation Association

Neighborhood Health Clinics

North Portland Nurse Practitioner Clinic

Oregon Association of Hospitals and Health Systems

Oregon Health Action Campaign

Oregon Health Science University

Outside In

Providence Health System

Tuality Healthcare

Wallace Medical Concern

Willamette Falls Hospital

 

Oregon Association of Hospitals and Health Systems Participants:

·          Kaiser Permanente                              Andee Petersen

·          Legacy Health System                        Pamela Vukovich

·          Portland Adventist                             Mark Perry

·          Providence Health System                  Terry Smith

·          Tuality Healthcare                               Tim Fleischmann

·          University Hospital                             Aaron Crane

·          Willamette Falls Hospital                    Tim Blanchard

·          OAHHS                                              Ken Rutledge

OAHHS Business Services Committee Participants:

·          Kaiser Permanente                              Dan Remington

·          Legacy Health System                        Kathie Dias, Earlene Phillips

·          Portland Adventist                             Kenneth Mitchell, Donna Krenzler

·          Providence Health System                  Teresa Spalding

·          Tuality Healthcare                               Jean Smith, Jackie Nutt

·          University Hospital                             Debra Tomsen

·          Willamette Falls Hospital                    Dawn Burns, Carol Duncan

·          OAHHS                                              Kent Ballentyne

 

TABLE OF CONTENTS

BEST PRACTICES                                                                                                                    1-9

                                                            Foundation of the Best Practices Agreement                    1-2

                                                            Comments by OHAC on Committees Best Practice Recommendations       3-5

                                                            Best Practice Recommendations Offered by OHAC       6-7

                                                            Best Practice Agreement                                                   8-9

COMMON PRACTICES                                                                                                       10-11

                                                            Financial Assistance Screening                                           10

                                                            Safety Net Assistance Application

                                                            Sample Hospital Statement

                                                            Account Follow-up and Collection Practice                       11

LEGAL PRACTICES                                                                                                                 12

                                                            Hospital Lien Clarification                                                 12

                                                            Portland Service Area Bankruptcy Review                        12

COMMUNICATION                                                                                                              13-15

                                                            Sample Brochure #1                                                            13

                                                            Sample Brochure #2                                                            14

                                                            Sample Business Cards                                                       15

                                                            Sample Wall Sign                                                                15

NEXT STEPS                                                                                                                          16-19

                                                            Financial Assistance Policy                                                 16

                                                            Employee Education Program                                            16

                                                            Ongoing Monitoring                                                           16

                                                            Annual Follow-up Meeting                                                 16

                                                            Sample Financial Assistance Policy                               17-19

MISCELLANEOUS                                                                                                               20-26

                                                            Minutes from OAHHS and OHAC Board Meeting     20-21

                                                            Minutes from OAHHS and
OHAC Update on Committee                                  22-23

                                                            Meeting Schedule and Plans                                    24-26

 

 BEST PRACTICES

FOUNDATION OF THE BEST PRACTICES AGREEMENT

On September 12, 2000, Portland area members of the Oregon Association of Hospitals and Health Systems (OAHHS) met with representatives of the Oregon Health Action Campaign (OHAC) to discuss "best practices" in financial assistance.  It was agreed that hospitals would convene a local task force with a goal of establishing a consistent and standardized approach to financial assistance/charity.  As a beginning, OHAC outlined "best practices" in the areas of income guidelines, cultural accessibility, public and employee awareness, user friendly standardized application, and collection and lien practices (pg. 7-8).  Existing practices of Portland area hospitals will be evaluated to determine "best practices."

For the past few months, representatives of Portland OAHHS member hospitals participated in the assigned task force reviewing and seeking to implement the best practices from OHAC and existing financial assistance programs available within the community.

Consensus was reached on a core level of financial assistance best practices including:

CORE LEVEL AGREEMENTS AMONG GREATER PORTLAND AREA HOSPITALS:

ü         Hospital policies will reflect the core level agreements.

ü         Minimum assistance levels are tied to Federal Poverty Guidelines (FPG).