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Community Medical Centers provided nearly $152 million in uncompensated services and programs in fiscal year 2012/2013, equivalent to 12% of its total expenses, according to the nonprofit hospital system’s annual community benefits report filed with the State of California.
Community has historically spent more on uncompensated community benefits than all other Fresno-area hospitals combined. And, some years, nearly double the combined total of other area hospitals.
The “community benefits” figure reflects the costs of services and programs for which the hospital system is not paid. It does not include bad debt.
The community benefits total for 2012/2013 includes charity care, unpaid costs of public programs for the medically underserved (including Medi-Cal and the medically indigent services program – MISP – as part of Community’s contract with Fresno County) and the costs of educating health professionals as part of a longstanding partnership with the Fresno medical education program of the University of California, San Francisco.
By comparison, Community’s uncompensated community benefits for fiscal year 2011/2012 were nearly $139 million.
Community and other California hospitals serving large numbers of Medi-Cal patients have been reimbursed from a temporary “provider fee” that pulls in supplemental federal funds. For Community, the provider-fee reimbursement was $68 million in fiscal year 2012/13 and $64 million in fiscal year 2011/2012. That fee was not designed by lawmakers as a long-term source of reimbursement for hospitals and is expected to end in December 2016.
Community continues to experience additional expenses from its contract with Fresno County. In February 2010 and again in December 2010, Fresno County expanded the eligibility ranges for those seeking MISP benefits. As a result, Community has seen significant increases in the numbers of MISP patients coming for treatment and additional costs for providing care, without any additional recompense from the county.
Last fiscal year, Community provided care to 17,000 MISP, jail inmates and juvenile offenders. Community’s estimated (unaudited) cost for providing this care last year was $103.7 million, which included about $4 million in care for jail inmates and juvenile offenders. The county’s payment to Community was $21.1 million. Thus, Community’s estimated shortfall for caring for the county MISP, inmates and juvenile offenders was $82.6 million last year.
The combination of the region’s longstanding high jobless rate, the nation’s slow economic recovery and the complexity of implementing federal healthcare reform has increased the numbers of patients coming to Community who have limited or no ability to pay for the cost of their care.
“We are the region’s safety net, and we care for patients regardless of their economic hardships,” said Tim A. Joslin, Community’s chief executive officer. “That said, reductions in some government reimbursements and having to cover the additional costs of those who can’t pay their often high insurance deductibles pose special challenges for us.”
“We’re doing our best to address these challenges,” said Joslin, “in part by continuing to invest in our staff and in technology and by developing new models of care.”
Community operates three acute-care hospitals, including the only combined burn and Level 1 trauma units between Los Angeles and Sacramento, and numerous other health facilities. It is the region’s largest private employer with more than 7,000 employees, more than 1,300 affiliated physicians and more than 900 volunteers. Community also serves as the region’s safety net, through its 1996 contract with Fresno County.
As a condition for tax-exempt status, nonprofit hospitals such as Community are required by state law to report the uncompensated benefits they provide each year.
This story was reported by John G. Taylor. He can be reached at firstname.lastname@example.org.