San Francisco General hikes fees to help offset hospital cuts

A visit to San Francisco’s only trauma center might cost patients an additional $2,280 next fiscal year, making the cheapest treatment $10,000 even for people who are not admitted.

Meanwhile, The City’s Public Health Department hopes to raise the price of all other services by 10 percent at the county-owned San Francisco General Hospital.

The two increases are expected to generate almost $6 million in revenue for the Public Health Department. Chief Financial Officer Gregg Sass said the money will help offset rising medical costs while complying with a mandated cut of 10 percent from its budget of about $348 million.

But because San Francisco General primarily serves uninsured and underinsured patients who often end up not paying their medical bills, the bulk of the price hikes will be covered by the tiny subset of patients who have private insurance.

“It is key that the only people responsible for those charges are usually the ones who have private insurance,” Sass said. “It’s really a very small percentage.”

When it comes to trauma care in San Francisco, even privately insured patients have no alternative.

The trauma center at San Francisco General is The City’s only such facility, serving all critically injured patients with fast, intensive evaluation. About 3,250 patients used the center in the 2008-09 fiscal year, Sass said, and approximately 30 percent of those visits resulted in admittance.

Last year, San Francisco General raised its prices 10 percent. Yet, Sass said, the rates are still significantly lower than those found at private hospitals.

Fees aside, he said the department hopes to balance the remainder of its budget by investing more money in hospital services to attract more federal and state incentives.

For example, Sass said the department can receive about $39.9 million from a state incentive pool by investing about $20 million in projects that improve timely services. The proposal includes hiring about 49 employees, improving human resources and other projects.

Officials say patients should look forward to shorter wait times and a better electronic health record system, among other expansions, to meet grant requirements.

Health Commissioner James Illig, who said fee hikes are part of normal business, said the department’s budget is looking good.

“Extra revenue is what’s saving us,” he said.

However, Illig said he is more worried about the so-called “contingency” proposals, a second set of cuts that every city department is being required to prepare in case San Francisco’s financial situation turns out to be worse than expected. The Public Health Department has to propose an extra $27.4 million in cuts.

“Hopefully they won’t have to use the contingency, but that’s what we’re afraid of,” Illig said.

The Health Commission is scheduled to vote on the budget at its April 5 meeting. The rate hikes will have to be approved separately, then also by the Board of Supervisors.

Cost of trauma care

San Francisco General Hospital is changing its trauma-care prices to generate an additional $940,000.

Current pricing structure
– SFG now uses three tiers of pricing: $7,780, $14,262, $16,500

New pricing structure
– Current structure will be replaced by system in which every trauma case costs either $10,000 or $16,000

Source: Public Health Department

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