Insurance contracts to help UMC

Monday, Oct. 4, 2004 | 9:22 a.m.

University Medical Center will begin reaping the benefits of large new pools of potential paying customers, Clark County officials said this week.

The County Commission on Tuesday is expected to approve a contract with health-insurance provider First Choice, which means that up to 10,000 of the company's covered patients will be able to use the county hospital's outpatient services. The move comes two weeks after the commission approved a similar contract with Blue Cross-Blue Shield for about 168,000 covered patients.

Lacy Thomas, UMC chief executive officer, said the contracts mean that the hospital and its outpatient services have a growing pool of paying customers, which is important to the hospital because of the heavy financial burden it carries in covering uninsured and indigent patients.

"It means we have the kind of patient mix we need to have in terms of keeping the financial pressure off the taxpayer," Thomas said. "Blue Cross has about 168,000 lives (people) they cover in the Las Vegas area. If we get a third of that, we get a significant increase in our commercial base."

Thomas said the contract doesn't mean the insured patients have to come to UMC or the hospital's Quick Care urgent care centers when they need medical attention, but they have the option, knowing that their services should be covered.

"It puts us in the position to market to that payer community and gives our outpatient services to have those payers as potential customers," Thomas said.

Two years ago, UMC and its associated Quick Care network were on the fiscal ropes, a problem some attributed to the rise in the number of uninsured patients who were turning to the medical system for health care.

Since then, UMC's administrators have cut costs and taken other steps to improve the bottom line. One of the goals established during the fiscal crisis was to expand its base of customers covered by insurance.

Observers agreed that the contracts are good news for the county.

"Obviously, it strengthens University Medical Center, and for the taxpayers, it should mean that they are able to have compensation for more of their patients, which means they can carry on the requirements to be available for those who cannot pay," said Larry Matheis, executive director of the Nevada State Medical Association.

He said it also indicates that UMC has the range and quality of services to win approval from those insurance plans.

"It means that these plans have reviewed UMC and found that it meets the needs of their covered patients," Matheis said.

Dr. Michael Colletti, president of the Clark County Medical Society, agreed.

"If UMC can be more self-supporting and not depend on tax dollars, that's good," Colletti said. "It will help UMC compete with other hospitals."