The giant safety-net hospital responds to healthcare reform, high-deductible health plans, and concerns about equity by rebranding and expanding its charity care program.
H. Gene Lawson
Like many provider organizations, Parkland Health & Hospital System—the famed 968-bed, safety-net institution based in Dallas—has seen an increase in patients with high-deductible health plans over the past year.
As more patients purchase coverage through health insurance exchanges to comply with the Patient Protection and Affordable Care Act's individual mandate, the system's leadership expects that trend to continue in 2015 and beyond, says H. Gene Lawson, Parkland's senior vice president, revenue cycle.
"Thousands of people signed up for ACA plans in the first year. These are poor people who a year ago got charity care. Now they have insurance plans with very high deductibles and out-of-pocket costs, and that number will increase because a lot more people signed up this year for those plans," he says.
Making charity care more inclusive
To keep pace with this shifting financial landscape, Parkland recently announced that it is rebranding and expanding its existing charity care program to include a broader spectrum of patients. As of March 1, the system is replacing its Parkland HEALTHplus charity care program with the Parkland Financial Assistance program.
The reason for the change is threefold, Lawson says: to clarify what the program offers, to help more patients meet their financial obligations to the hospital, and to prevent patients from avoiding necessary medical care.
"The name Parkland HEALTHplus was misleading for some people because it sounded like a health plan. Some people weren't applying for ACA plans because they thought they already had an insurance plan so we needed to address that," Lawson says.
Additionally, Parkland wanted to provide some assistance to low-income patients who do have a health plan but still struggle to pay their bills. The new program has been overhauled to include more patients.
"We revamped the plan to include people who are at 200% of the federal poverty level. We don't write off their copays or deductibles, but we do take it down to a level that is based on their income and their ability to pay," Lawson says, noting that the new policy is also designed to make Parkland's charity care more equitable.
"With the introduction of the ACA marketplace plans a year ago, we realized we had some inequities in our charity care policies. We gave millions of dollars in charity care to undocumented people, but if you are legal, you had to purchase insurance and could no longer qualify for free care. What we are really doing is being consistent in our charity guidelines so that we are only charging people what they can afford to pay," he says.
Rene Letourneau is a contributing writer at HealthLeaders Media.