Becker's Hospital Review

52 CFO / FINANCE West Virginia University Health System looks to add 9th hospital By Ayla Ellison B raxton County Memorial Hospital in Gassaway, W.Va., signed a letter of intent to joint Morgantown-based West Virginia University Health System. West Virginia University Health System President and CEO Albert L. Wright Jr., PharmD, expressed excitement about acquiring the 25-bed critical access hospital. "Braxton County is uniquely positioned right in the center of West Virginia, and it's important for the people who live in the heart of our state to have access to the high-quality healthcare they need," he said in a press release. "We are proud to welcome Braxton County Memorial Hospital to our system, and we look forward to being a part of that community." The health system said a certificate of need application will be filed with the West Virginia Health Care Authority. If the state approves the transaction and the deal closes, Braxton County Memorial Hospital will be West Virginia University Health System's ninth hospital. n Texas hospital reduces patient's $109K balance bill to $332 after media coverage By Morgan Haefner A ustin, Texas-based St. David's HealthCare resolved a pa- tient's $108,951 balance shortly after Kaiser Health News and NPR published a story about the patient's out-of-net- work medical bill. St. David's, a part of Nashville, Tenn.-based HCA Healthcare, said it would accept $332.29 to resolve Drew Calver's bill. The hospital said Mr. Calver qualifies for a financial assistance discount. "In a statement, the hospital said this offer was contingent on [Mr.] Calver submitting his application for a discount based on his household finances," according to KHN. Mr. Calver went to St. David's Medical Center's emergency room April 2, 2017, after suffering a heart attack. ER physicians admit- ted Mr. Calver to St. David's cardiac unit. The next day, physicians placed stents in his clogged artery. The hospital, which is out of network for Mr. Calver's employ- er-sponsored Aetna health plan, charged $164,941 for the sur- gery. His health plan covered $55,840 of the bill, leaving Mr. Calver on the hook for $108,951 — nearly twice the amount of his yearly salary as a teacher. At the time of publication, St. David's defended its billing practices to KHN: "While we did everything right in this particular situation, the structure of the patient's insurance plan as a narrow network product placed a large portion of the financial responsibility di- rectly on the patient because our hospital was not in-network." n Pennsylvania man receives 2 echocardiograms at same hospital — one cost $170, the other $3,101 By Morgan Haefner A Pennsylvania man received two echocardiograms at Paoli (Pa.) Hospital: the first diagnosed a heart defect, and the second was to confirm a procedure was successful. e price was $339 for the first and $3,484 for the latter, according to e Philadelphia Inquirer. Here are five highlights from the report: 1. George Hahn's first heart scan was administered by Car- diology Consultants of Philadelphia in February 2017. e group has offices within Paoli Hospital, a part of Radnor, Pa.- based Main Line Health. e cardiology group also contracts with Mr. Hahn's health insurer, Independence Blue Cross, which negotiated a large discount for the test. 2. e group, which has its own ultrasound machines in the hospital-based office, billed Independence $1,335 for the echo- cardiogram. Independence negotiated the price down to $339. Since Mr. Hahn had met his deductible, the insurer paid half of his bill and Mr. Hahn owed $170, according to e Inquirer. 3. e echocardiogram revealed Mr. Hahn had a small hole in his heart. Aer he underwent surgery at another Main Line Health hospital, his cardiologist referred him to Paoli Hospital for a second echocardiogram to confirm the pro- cedure was a success. 4. e test was performed in April by the hospital, which is in Independence's provider network, and not the cardiolo- gy group. Paoli Hospital billed Independence $3,484 for the test — more than double what the cardiology group in the hospital billed the insurer. Bonnie Graham, vice president of finance for Main Line Health, told e Inquirer the hospital's charge reflects the higher administrative and operating ex- penses it faces compared to provider groups. 5. Independence negotiated Paoli Hospital's charge to $3,101. Mr. Hahn was charged the full amount, as he has not met his deductible yet. Anthony Coletta, MD, president of Facilitat- ed Health Networks at Independence, told the publication, "We want to give our members options by providing a broad network of participating providers, and the ability to go to different sites for services. At the same time, we try to make our members aware that it almost always costs more for non-complex, routine procedures to be done at a hospital." n

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