HCA
#Thank you, <UNK>.
This is <UNK>.
Last year we stepped up our efforts in our communities.
We partnered with several agencies including Enroll America and others to try to reach out inside our communities where we believe there are still uninsured people who have the opportunity to participate.
We are going to continue to do that in our enrollment period.
We have a team and a committee of people that are working with our local markets.
And some third-party agencies, where we will be sponsoring community agencies, participating with other community events, and trying to reach out to the uninsured volume in our communities that we think still are able for subsidies.
We're trying to target that very thoughtfully in some of our key and larger markets where we have data that suggest there is still opportunity there.
I would characterize it ---+ we are active in that space and we are working diligently to try to reach out to that community.
<UNK>, I would add, I think most of you saw, HHS, of course they put projections which are pretty conservative I think going into next year.
But the good news is they also cited that they were going to put increased efforts in 5 different markets.
The good news is 3 of those 5 happen to be important markets to us.
One is Houston, one is Dallas, and one is Miami.
We don't care much about their New Jersey effort, or wherever the other one was [laughter], but those are 3 good ones for us.
So, thank you.
All right.
<UNK>.
Let me try your bad debts, and <UNK>, thanks for the question.
As you know we have historically looked at the total uncompensated care, which includes bad debts and uninsured and charity, and from period to period you can get some movement from one or the other.
With our slowdown in pending Medicaid conversions we saw this quarter, that does put a little bit more in the allowance for doubtful accounts, which flows through for bad debts.
But our total uncompensated care generally is moving in concert with what our uninsured trends are.
We have seen recent growth or continued growth of co-pays and deductibles.
That's not recent.
Our collection rates are staying really consistent with where they've been in the prior year, so we're not really seeing any erosion in collections.
Even though the co-pays and deductibles have grown our collection rates ---+ our collection amounts ---+ are remaining stable.
The largest factor on our uncompensated care continues to remain the uninsured growth.
On the inpatient status, we would need to get back with you on that.
I need to flow through on that.
Yes.
All right.
We will follow up on that one <UNK>.
I'm not sure anybody has that answer.
Okay.
Thank you.
You missed it.
I will be happy to give it to you again, <UNK>.
Real quick.
Let me pull it up.
Our same-facilities charity care and uninsured discounts increased $525 million.
Charity care totaled $914 million which is a decline of $117 million from the prior year.
Uninsured discounts totaled $2.755 million which was an increase of $642,000.
Since he didn't listen I'm not sure we'll let you do the other two things.
[laughter]
Yes.
Let me just try to clarify.
We have a charity care policy that if you meet our charity guidelines we do write off 100% of your bill.
If you don't meet our charity guidelines and you are uninsured we apply an uninsured discount, which is basically reflective of what you would be billed if you were insured.
It's not 100% but it is a substantial portion of your bill, is written off as uninsured discount, and then the residual then goes through kind of the bad debt line item.
You also have movements going on with Medicaid and pending Medicaid that affects those two items as well.
Yes.
As I mentioned earlier we've seen over the past recent years a growth in the patient liability related to co-pays and deductibles and we still see that.
I'd call that in that 10% to 12% on a per-account basis, but our collections have remained relatively stable.
We've said, and we validated this recently, about 30% of our write-offs are attributable to the deductible and co's, and the balance to uninsured.
That really has not changed in the data that we've seen.
I would tell you that the deductible and co-pay environment is staying relatively stable for us.
Relative on a material way to our trends.
Most of that we are still collecting up front.
We still collect at least 33% of that up front.
Thank you, <UNK>.
Anybody want that.
No.
We got three no's.
[laughter]
I'll tell you what, we have got time for one last question.
All right.
<UNK>, thank you very much.
And I want to thank everyone, and hopefully I didn't offend anybody from New Jersey with my comments earlier.
It was not intended.
You all have a great day.
