Vanderbilt‘s Share of Charity Care Rising Fast

Providing charity care to Middle Tennessee‘s most financially vulnerable individuals is an expensive proposition — especially so for a large, comprehensive health care institution such as Vanderbilt University Medical Center, which, in addition to seeing the most patients, also sees the sickest.

According to the most recent figures available from the Tennessee Department of Health, Vanderbilt‘s hospitals and clinics provided nearly $31 million in charity care and care to the medically indigent in 2005.

That figure is nearly double the amount of the same type of care provided by Saint Thomas Hospital, Baptist Hospital and the four Nashville Tri-Star hospitals — combined. The charity/medically indigent care of those six hospitals totaled $17.6 million in 2005.

When bad debt is factored in, Vanderbilt‘s total uncompensated care — comprised of charity care, medically indigent care and bad debt — swells to a staggering $98.7 million. That figure dwarfs the charity care, medically indigent care and total uncompensated care figures reported by every other health care provider in the Nashville region.

In fact, the $98.7 million Vanderbilt‘s hospitals and clinics spent on uncompensated care in 2005 trailed only Memphis‘ Regional Medical Center (the Med) in the state, and is nearly as much as the combined total spent by the 10 largest health care providers in Nashville.

The numbers make it clear that, when compared with other hospitals in the area, Vanderbilt is truly the caretaker of Middle Tennesseans in need.

“Caring for its patients, no matter their ability to pay, is part of Vanderbilt‘s heritage,” said Harry Jacobson, M.D., vice chancellor for Health Affairs. “It is one of our core missions and is part of the heart, soul and very fabric of what a world-class medical center should be and is what Vanderbilt is all about.”

A peek inside the numbers makes the contrast with other area providers even more startling.

The amount of uncompensated care in relation to total number of licensed beds at Vanderbilt‘s hospitals and clinics stood at $122,610 per bed.

Though not the highest in the area — that expensive distinction belongs to Metro Nashville General Hospital, whose uncompensated care stood at $206,001 per licensed bed — VUMC‘s ratio was far higher than Baptist Hospital ($21,662 per licensed bed); Saint Thomas ($25,341); and the average of Tri-Star‘s four Nashville hospitals ($50,699).

As large as Vanderbilt‘s uncompensated care burden already may be, the load is only getting heavier. Sweeping changes to the state‘s TennCare system last year that cut benefits to thousands of Tennesseans are not reflected in the state‘s 2005 report.

More current numbers are staggering.

According to the Medical Center‘s Finance department, the total uncompensated care figure for Vanderbilt‘s hospitals and clinics has risen to $194.2 million in fiscal year 2006, a stunning 80 percent increase from Vanderbilt‘s previous fiscal year.

These figures don‘t factor in the possibility of additional state and federal funds being made available to health care institutions, like Vanderbilt, who are deemed ‘safety net‘ providers.