Grassley Questions Chicago Hospital with Ties to Obamas

Iowa Senator Charles Grassley is questioning how a Chicago hospital with ties to the wife of Democratic presidential candidate Barack Obama treats uninsured patients visiting its emergency department.

In an August 29th letter to the University of Chicago Medical Center, Grassley requests information about how much free and discounted care the hospital provides to the poor. The ranking Republican on the U.S. Senate Finance Committee also sought information about the South Side Health Collaborative, a program started by Michele Obama, who is on leave without pay from her job as vice president of community and external relations with the hospital. 

The Southside Health Collaborative program is part of the hospital’s initiative to lower the number of people seeking routine care in its emergency room. It was designed to help area residents who don’t have a medical home connect with primary care providers in their neighborhoods.

Grassley said in a press release that an August story in The Washington Post last describing the hospital’s efforts to steer under-insured and uninsured patients away from the hospital to clinics prompted the inquiry because it “appears to be culling the least profitable patients from its emergency room.”

“The answers to the questions I’m asking are critical to understanding whether these hospitals are setting standards for their peers. Those standards might include losing sight of the public service that comes with tax-exempt status," said Grassley, whose questions about not-for-profit hospital charity care practices led the Internal Revenue Service to require tax-exempt hospitals to detail their charity care and bad debt expense policies.

Experts say uninsured patients have turned to emergency departments because of limited access to primary care, (“Emergency Room Visits Rise as Primary Care Access Drops,” June 9), but that treating patients, insured and uninsured, for non-urgent conditions via emergency departments drives up the cost of health care and hospitals bad debt expense.

As a result, hospitals are fighting back with their own initiatives. The study, “Safety Net Hospital Emergency Departments: Creating Safety Values for Non-Urgent Care,” from the Center for Studying Health System Change (HSC), found that hospitals throughout the country have launched programs, including opening clinics to help uninsured and underinsured patients find routine medical care.

“It’s an industry trend and not unique to that hospital,” said Jeffrey Englander, a Standard & Poor healthcare facilities analyst. “It’s all hospitals trying to reduce the levels of uncompensated care by treating non-acute cases outside of the emergency room where it’s appropriate.”