This is an archived article that was published on sltrib.com in 2005, and information in the article may be outdated. It is provided only for personal research purposes and may not be reprinted.
Intermountain Health Care promises to sue fewer patients with unpaid medical bills and to provide greater access to doctors and hospitals outside the IHC network.
The announcement was made Wednesday, mere months after state lawmakers blistered IHC for aggressive collection tactics and punitive insurance policies, saying if the company operates like a for-profit company, perhaps is should be taxed like one.
Responding to such criticism, IHC will cut interest rates for patients on payment plans and make it easier for them to resolve billing problems. Also, said IHC Chief Financial Officer Bert Zimmerli, IHC will not take patients to court for unpaid medical bills unless there is evidence of fraud or the individual clearly can afford to pay but won't.
Currently one in every 1,000 patient bills is delinquent and referred to the courts, IHC estimates. That could drop to one in 4,000 under the new plan. Salt Lake City bankruptcy attorney Michael Roberts predicts fewer bankruptcies as a result.
"This is a big deal," he said. "Almost every day I see a judgment in favor of IHC."
All of the changes will result in a dramatic increase in the amount of charity care IHC provides each year, Zimmerli said.
"Obviously all the care can't be free to everybody," he said. "[But] the fear of a medical bill should never impede anyone from getting the help they need."
Zimmerli said the changes had been in the works for months, the second phase of improvements that began in November when IHC expanded discounts for low income patients.
There is no doubt, however, that the effort took on more urgency as a result of recent legislative debate and the testimony that fueled it. Patients complained about restrictive insurance plans that control what doctors they can see. Others said they were dogged by bill collectors and pushed to the brink of bankruptcy. Doctors complained that IHC, through its network of hospitals, doctors and insurance policies, operates like a monopoly.
Lawmakers considered taxing the company or forcing it to divest itself from the insurance business, but instead created a task force to study that and other health care issues. Task force chairman Sen. Michael Waddoups of Taylorsville said the changes announced this year and last reflect the company's willingness to address public concern but the study group will go forward and report on the health care giant in November of this year and in November 2006. It will meet for the first time in May and twice monthly leading up to the legislative session.
Meantime, IHC said it will establish an ombudsman's office to serve as an advocate for patients with unresolved billing problems and several citizen advisory groups to provide IHC with input about its billing and collection policies.
To address complaints from patients wanting to visit doctors outside the IHC network, a new preferred provider plan will allow policyholders to access all qualified physicians and facilities, although it undoubtedly will cost more than other plans in which patients are more limited on which physicians and facilities they may use.
Additionally, the company no longer will lease its physician panels to other insurance providers in Utah, a move lauded by the Utah Medical Association.
Panels are groups of physicians that agree to accept certain types of insurance coverages. Most major insurance companies have their own panels, although a number of smaller insurers lease theirs from IHC.
Val Bateman, executive vice president of the Utah Medical Association, said physicians have had some trouble in the past with some small insurance companies that have used IHC's panel.
"We are very much in favor of this change," he said.
Company's new policies
l The major changes: IHC won't use court orders to collect unpaid medical bills unless there is evidence of fraud or if an individual has enough money to pay but refuses to do so. Interest rate for patients on a payment plan will drop from 14.5 percent to 8 percent, and some low-income patients will pay no interest at all.
l Who benefits: Anyone who cannot afford to pay their bill or is making payments over time.
l For more information: Call IHC's help line at 800-442-1128 or 442-1128 or log on to http://www.ihc.com.