Becker's Hospital Review

14 CFO / FINANCE Hospital CEO responds to patient billed $142 for chat with physician during physical By Kelly Gooch T he CEO of Grand Rapids, Mich.- based Spectrum Health is advocating for more billing transparency, aer a complaint highlighted expenses a patient in- curred as a result of her annual exam, accord- ing to NBC-affiliate station WOOD-TV. "We agree with you that a more trans- parent process is necessary," Spectrum Health President and CEO Tina Freese Decker wrote to the patient in an email re- sponse cited by the station. "I have shared your suggestion (for additional transpar- ency) with our Spectrum Health Medical Group leadership so that we can apply this suggestion into our workflow." At issue is billing for physician visits. e patient, who remained anonymous, said in an email to Ms. Freese Decker that she incurred $142 in additional charges because she briefly discussed certain issues with her physician during her annual exam at a Spectrum Health Medical Group location, according to WOOD. "She didn't do any additional treatment, test- ing or prescribe me anything. ere was no follow-up scheduled. ere was no indication that this was anything other than a typical conversation one might have with their new doctor," the patient wrote. e patient said in her complaint to Spec- trum Health that she was told by billing that she was charged for an additional consulta- tion because issues she discussed during her annual exam were not considered preventive. erefore, the second charge was not covered by her insurance company, even though the wellness visit was. Since February, when Ms. Freese Decker re- sponded to the patient's complaint, Spectrum Health has formed a group "to evaluate the issue and look at best practices of other health systems across the country," a health system spokesperson told the station. "We want to find a solution that alleviates this concern for patients and at the same time ensures we are compliant with bill- ing and coding regulations. We realize the billing process can be confusing and are committed to transparency with our pa- tients," the spokesperson added. n UPMC's revenue climbs to $5.1B in first 3 months of 2019 By Kelly Gooch U PMC reported year-over-year increases in revenue and net income in the first three months of 2019, but the Pitts- burgh-based health system ended the period with lower operating income. Six things to know: 1. UPMC reported revenue of $5.1 billion in the quarter end- ed March 31, up 10 percent from $4.6 billion in the same three months of 2018. 2. The revenue growth was partially attributable to increased en- rollment in UPMC's health insurance plan. Enrollment grew to 3.5 million members as of March 31, up 3 percent compared to the first three months of 2018. 3. Expenses grew 11.5 percent year over year in the first three months of 2019. 4. After accounting for expenses, UPMC ended the first three months of 2019 with operating income of $51 million. That's down from $92 million, or 44 percent, from the same period a year prior. 5. The system reported net income of $289 million in the first three months of 2019, up from $97 million reported in the first three months of 2018. The boost is largely attributable to gains from in- vesting and financing activities. 6. UPMC reported an operating margin of 1 percent for the first three months of 2019, down from a 2 percent operating margin in the same period last year. n BJC HealthCare more than doubles net income year-to-date By Morgan Haefner B JC HealthCare, a nonprofit 15-hospital health system in St. Louis, saw its revenues and net income improve in the first quar- ter of fiscal year 2019, according to unaudited financial documents. Four things to know: 1. In the quarter ended March 31, BJC HealthCare re- corded total operating revenues of $1.4 billion, up 3.1 percent from $1.3 billion reported in the same period a year prior. During that time, BJC HealthCare saw net patient revenues increase 3.3 percent. 2. The health system posted total operating expenses of $1.3 billion year-to-date, up 2.2 percent from the year prior. Increases in salaries and benefits, as well as supply costs, contributed to the uptick. 3. BJC HealthCare recorded $45.6 million in operating income during the most recent period, up 39.9 percent from $32.6 million in the same period of fiscal 2018. 4. After including a $114 million increase in nonoperat- ing income, BJC HealthCare ended the period with net income of $209.7 million, more than double the $82.7 million posted in the same period a year prior. n

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