Hospital funding formula for indigent care studied

Adrienne Packer

Wednesday, April 4, 2001 | 10:50 a.m.

An antiquated formula that determined which Las Vegas Valley hospitals would be compensated for treating indigent patients soon will be revamped with hopes a newer system will improve accessibility to medical care.

Until a new formula is created, however, Clark County commissioners agreed to give a portion of its Disproportionate Indigent Share Hospitals (DISH) funds to Lake Mead Hospital and Medical Center.

"We need to make sure we provide medical services to people who need it," Commissioner Yvonne Atkinson Gates said. "If you take a significant amount of indigent patients, you should be compensated for taking care of those indigents."

Lake Mead and Sunrise Hospital and Medical Center claimed last year they both met the DISH funding criteria established in 1993 that says hospitals are eligible if 20 percent of their inpatients are uninsured or low-income residents.

A study released Tuesday showed that last year 17 percent of Sunrise's inpatients were considered indigent and 36 percent of Lake Mead's patients fell into the category.

Nearly 75 percent of the inpatients treated last year at University Medical Center, a facility operated by Clark County, were indigent.

Although Lake Mead is a for-profit hospital, county commissioners said it deserved a share of the funds because of the number of poor patients it serves -- second only to UMC.

The study performed by the accounting firm of Deloitte & Touche suggested the county create a new formula that is more equitable and "recognizes the risk and effort associated with a hospital's care to indigent patients."

Deloitte and Touche also recommended the county provide its own oversight of each hospital's total indigent inpatient days each year.

The study compared Clark County to New Mexico; Orange County, Calif.; Tampa-Hillsborough County, Fla.; and Milwaukee -- areas with a comparable number of uninsured residents.

Clark County was most unique because it compensates for low-income patients and working-class residents. The other entities compensate all hospitals that treat low-income patients.

"We're providing service for a greater number of people," Atkinson Gates said.

Commissioners directed administrative staff to look at the financial impacts different formulas would have on the county. Administrators are scheduled to report back to the board in about two months.