Why I Love My Job

Okay guys,
This one will be longer than my last, but it truly speaks to why I am so proud to work for BJC HealthCare. I feel very fortunate that most days I truly do love my job (notice, I said "most" not "all"). I have worked for government, private industry and now not-for-profit and found really smart people in all three sectors. But, nowhere have I found employees so committed to their mission as in health care. As you read the commentary below by Steve, I hope it helps you remember the very good work that is done each and everyday at BJC HealthCare and the very important part you play in making it happen!
J

Community Benefit goes beyond Charity Care

Last month, a woman arrived in the emergency department. She was alone, she was in pain and she was frightened. To make matters worse, she did not speak English. She was unable to tell the doctor and nurse what was wrong, and she could not understand the questions they asked of her. Within a few minutes, an interpreter arrived from the hospital’s refugee health and interpreter services, a free service available around the clock to bridge the language and cultural gap between patients and caregivers. The relief of being able to communicate undoubtedly served to lessen the anxiety of the patient’s medical crisis. Hers is one of more than 32,000 such encounters each year that are made possible through this special service at Barnes-Jewish Hospital.
Is providing an interpreter for non-English speaking patients a benefit to patients and the community? Is such a benefit of as much value as charity care?
Apparently not, according to the St. Louis Post-Dispatch. In recent coverage (a business section article on Sept. 3 followed by an editorial on Sept. 7), the newspaper espouses a narrow definition of “community benefit” as charity care and charity care alone.
In reality, charity care is only one element of community benefit – albeit an important and obvious one. In 2007, the hospitals of BJC HealthCare provided more than $50 million in charity care, more than any other health care organization in Missouri. BJC also subsidized $230 million in underpayments from Medicare and Medicaid and provided an additional $68 million in unreimbursed care that patients were unable to afford.
Our charity care programs are among the most generous in the nation. Many programs across the country provide discounts for family incomes up to 200% of the federal poverty limit while BJC offers discounts for patients in families earning up to 400% of the federal poverty level. Additionally, as part of a pending lawsuit settlement, BJC has enhanced this program by offering automatic discounts of 25% for any patient without insurance, regardless of their income.
Misrepresentations continue to appear in the news media regarding nonprofit hospitals and charity care. What seems to repeatedly get lost in translation is that charity care is just one aspect of the obligation hospitals have to their communities. Nonprofit hospitals, in return for their tax-free status, are obligated to provide many community benefits to those they serve. In a community without a public hospital, maintaining nonprofit status for hospitals is the best way to ensure the uninsured and underinsured continue to have access to vital health care services. While taxing hospitals would provide revenues to local, state and federal governments, there is no guarantee that those revenues would be used to provide access to health care for the uninsured.
The definition of community benefit extends beyond this uncompensated care, however, to vital services and programs that would not and could not exist unless hospitals provided them. For example, BJC invested more than $80 million in medical and nursing education, contributed nearly $16 million toward bio-medical research and provided more than $14 million in community outreach efforts during 2007.
That’s a total of $458 million in free medical care, health professions education, medical research and community benefit programs like interpreter services, mammography screenings for low-income women, health screenings in underserved communities and teen smoking cessation programs in area schools, to name but a few. These community benefit programs are no less important than direct medical care, but they go unreported by the Post-Dispatch, and appear to be less appreciated and under-valued. Taken together, these community benefit expenditures add up to almost 15% of BJC operating revenues – substantially more than the 1.75% of revenues attributable to charity care alone.
To someone in medical distress, who does not speak English, or to a woman who cannot otherwise afford a mammogram or to a teen on the brink of a lifelong addiction to nicotine, these programs can and do make an immediate and important difference. Rather than being ignored or disregarded, community benefit programs should be encouraged and embraced by the Post-Dispatch as true investments in the community, just like charity care.

Steven H. Lipstein
President & Chief Executive Officer
BJC HealthCare