The D.C. General Hospital Commission acted last night to make the city's only public acute-care hospital at least partially self-supporting for the first time in recent memory.
After years of public discussion about the hospital's failure to collect payment from patients, insurance companies or the government, the commission - which took over control of the hospital last fall - voted to insituate a fee schedule and a new billing and collection program.
According to commission chairman Gilbert Hahn, "47 percent of our inpatients are covered by Medicaid, Medicare or private insurance."
Very little attempt has been made in the past to collect fees from the various insurers because, particularly in the case of Medicaid, the joint city-federal health insurance program for the poor, all the funds went to the city, rather than to the hospital.
Hahn said that in addition to not collecting fees - and some have estimated that the hospital has let upward of $100 million stand uncollected - "we really have not been the major collector of information or collector of payment."
The task of making collections and gathering information fell in the past to the city's Department of Human Resources, which ran the hospital as part of the city system until the commission took over last year.
The billing and collection process would be made possible by the installation of a new $2.5 million computer system for the hospital. According to Hahn, the computer will include the Medicaid, Medicare and Blue Cross enrollment information for the city, making it possible for the hospital properly to bill even those patients who fail to produce insurance information.
The 53 percent of the hospital's patients who do not have insurance will be billed on a sliding scale. Hahn said, based on their ability to pay.
"We may also find that a larger proportion is eligible for some form of insurance," he said, once the computer is in use.
According to Hahn, if all goes as predicted, the hospital should be able to collect about half the money needed to fund a budget ranging between $44.7 million and about $52 million.