HFMA VIEWS

Richard L. Clarke, DHA, FHFMA
President and CEO, HFMA

A recent ruling illustrates why it’s so critical for hospitals to foster trust in the communities they serve.

Hospitals--particularly not-for-profit hospitals--are among the most important assets that any community has. Residents put enormous trust in hospitals to meet their healthcare needs and to enhance quality of life for the entire community. For those who are unable to pay for the cost of their care, community hospitals are places they can trust in times of crisis.

But health care is a complex business, and difficulties explaining that business can make trust falter.

In 2003, the Urbana, Ill., county board of review recommended that the state refuse to renew Provena Covenant Medical Center’s application for tax-exempt status, citing overly aggressive attempts to collect money from poor and uninsured patients. The Illinois Department of Revenue revoked Provena’s tax-exempt status in 2004, a decision that has cost the hospital $5 million in property taxes. This September, the department denied Provena’s appeal to regain its tax-exempt status.

Provena president and CEO William Foley called the decision “a crisis for Provena Covenant and a national crisis for non-profit hospitals.” The Illinois Hospital Association agreed, saying the decision ignores nearly 100 years of legal precedents and public policy in Illinois.

The most recent ruling in the Provena case, whether it is upheld or not, is alarming news for not-for-profit hospitals. It’s an example of why it is so important for hospitals--all hospitals, both for-profit and not-for-profit--to earn the trust of their communities and to protect that trust.

How can hospitals build trust with the communities they serve? One way is to share how hospitals are giving back to their communities each day, whether through services that generate little or no revenue, free screenings, support of healthcare clinics for the indigent, and other initiatives that improve quality of life for the entire community.

It’s not enough to present this information once a year in an annual report. Consumers need to hear about the community benefit that their hospitals provide on a regular basis. Most of all, they need to see it in action. Consider testimonials from patients, employees, and others who can describe the impact that the hospital is having on quality of life in the community. Create PowerPoint presentations on community benefit initiatives that can be shared with chambers of commerce, rotary clubs, senior citizen groups, and government entities. Develop advertisements that promote the goodwill of the organization.

The financial management of health care is the most difficult aspect to explain to stakeholders. The latest PATIENT FRIENDLY BILLING® report, Consumerism in Health Care, includes 11 action steps that hospitals can take to help patients better understand the financial aspects of health services. These action steps are more than a public-relations strategy during an era of consumer-directed care. They demonstrate commitment to enhancing the patient experience, both on the care side and on the financial side. And HFMA’s Principles and Practices Board Statement No. 15 provides standards for measuring and reporting uncompensated care.

Actions such as these require time, energy, and courage from healthcare leaders. But they are critical to demonstrate that your community’s trust is deserved.