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Hospital changes pricing policy

Sonoma Valley Hospital has updated its pricing policies in an effort to ease financial pains in the face of rising health-care costs. With different tiers for different incomes, the new policy will streamline billing for patients as well.

“We aim to be the community’s first choice for health care for our community and if our prices are perceived as prohibitive, patients may seek care elsewhere,” said hospital Chief Executive Officer Kelly Mather. “Our vision is to be the indispensable link for health care in our community regardless of ability to pay. It is our sincere hope that the ‘price’ of getting health care locally is perceived as the best value and thereby, the best choice for everyone.”

The tiers include discounts for those without insurance who pay out of pocket, discounts for those with high-deductible health-care plans and free treatments for those who qualify for the hospital’s charitable care program.

“We have always had a self-pay discount policy,” said hospital Chief Financial Officer Rick Reid, explaining that it was clunky and confusing. “We wanted to make it straight forward, and easy to understand.”

Under the new policy, patients without insurance receive a 60 percent break on their bill. They’ll get another 10 percent off if they pay within 21 days of their first bill. With the new policy, the discount will automatically appear on bills to quell confusion.

“It used to be that the original bill would go out to the patient at 100 percent,” he said, explaining that it caused confusion and anxiety for patients. “The self-pay reduction is applied automatically, they don’t have to apply for it, they just get it.”

In 2011, 3.4 percent of patients who visited Sonoma Valley Hospital had no insurance whatsoever. Hospital officials say while the program was designed following California Hospital Association guidelines to benefit the community, it could also help the hospital as well. Patients who get massive bills they can’t possibly afford typically go into debt, while the discount program will encourage patients to pay a portion of their treatment costs at least.

“If it’s so big you can’t afford to pay anything, you don’t,” Reid said. “(This policy), it’s just better for everybody.”

The same can be said for the hospital’s high-deductible discount. Patients who have deductibles at $3,000 or higher can get 35 percent off their hospital bill, if they pay in full within 21 days of the first statement. On all bills, the hospital offers a no-interest payment plan where bills under $500 can be paid in six months, while balances over $500 can be stretched along 12 months.

But then there are those families with no ability to pay, but still have a need for health care. The hospital’s charitable care program means patients whose combined household income is under 200 percent of the Federal Poverty Income Guidelines do not have to pay anything on their bills. Families with incomes between 201 percent and 350 percent of the guidelines receive a 75 percent discount on bills; while those who fall between 351 percent and 450 percent get a 50 percent price reduction. But, Reid said, families must apply for the charitable care programs, which means providing recent tax returns.

“It’s for people who just don’t have the means to pay their bills,” Reid said, “but they have to provide certain documentation to qualify.”

Reid said this fiscal year, the hospital planned to significantly expand its charitable care program in the budget. To date since July, the hospital has provided more than $210,000 in free care to impoverished residents, including $163,214 in October alone.

“That’s compared to last year when we wrote off $15,000,” Reid said.

To inquire about discounts or the charitable care program, call Lisa Duarte at 935-5021.