Evening star., 1933-04-02
CHEST ADOPTS new
HOSPITAL POLICY
Flat Amount Per Patient to
Be Paid, Dropping Basis
of Deficits.

SOlIlululllty SiiCot Aidc d0Opbco u ueV
policy for financing community servic,
of hospitals, it was announced yester.
day by E. c. Graham, president of tht
Chest.
Under the new plan, member hospi.
tails will be paid at the rate Of maxi.
mum of 81 day per patient for free OF
part-pay ward service, rather than or
the basis of deficits or of actual cost
per patient per day. Explaining, Mr.
Graham said:
THE Community Chest cannot as
sumo responsibility for operating def
cits of hospitals"
''The policies of member hospitals
are determined by their Governing
Boards. These boards alone have the re-
sponsibility for the efficient and eco
nomical management of their respec-
tive hospitals and for the development
OF sufficient revenue to keep expenses OF
operation within the limits of income
THE responsibility of the Community
Chest is to reimburse member hospitals
at fair rate for the actual service
rendered to its beneficiaries The pa
tient day is the unit of hospital service
All hospitals are to be paid at the same
amount for the same unit of hospital
service rendered, without reference to
various costs of the hospitals"
Deficit Basis Unsatisfactory.
'"rhe idea is that while hospitals are
agencies for community service, con-
tributors should only pay for that serv-
ice reasonable amount based upon the
experience of the more economically
operated hospitals.
If the hospital cost in some hospitals
runs much higher than that, the deficit
on operations should be made up from
profit on pay patients rather than from
increased contributions from the con-
tributing public Community Chests
everywhere have not found it satisfac-
tory to finance hospitals on the basis
Of their deficits. In Washington the av-
erage hospital only gets about one
tenth of its income from contributions
and nine-tenths from payments by pay
patients. There seems no good reason
for control of the whole hospital budget
when only 10 per cent of it is actually
the concern of the Chests Budget
Committee. The plan of paying hos
pitfalls a fiat amount for each patient
day eliminates detailed budget work and
leaves each hospital free to manage its
own affairs IN its own way"
Explaining the method of payment
by the Chest, Mr.. Graham continued: :
From the total sum allocated to
member hospitals for the year 1898,
namely $293,000, has been deducted
the amount considered necessary for
the maintenance and operation of dis
pensaries, clinics and out-patient de-
partments as determined by the Budget
Committee after conference with agency
of1cials. The balance is set aside for
reimbursement to hospitals for in
patient service to the Community Chest
benef1ciaries.
Paid According to Sums Earned.
Hospitals are paid each month ac-
cording to the sums earned. Subject
to the limitations of available funds
member hospitals are reimbursed for
the care of such free and part pay pa
tients as may be eligible for Community
Chest aid at the maximum rate of SIS
per patient day. less such amount as
shall be charged to the patient for his
or her care after proper investigation
by social service worker or, if no
worker is available. by the superintend-
ent or his deputy.
- The 81 a day rate shall be used by
member hospitals in computing month
ly claims submitted to the Community
Chest for reimbursement unless men,
ber hospital has rate for ward care
to private hospitals lower than the
maximum rate allowed by the Commu-
nifty Chest; in which case the hospital
will compute its monthly claim for re-
endorsement on the basis of the lowest
rate as charged to the patient.
In other words the hospital Is not
required to charge S4 day for its ward
care. It charges whatever 1t pleases, but
the Community Chest only reimburses
1t at the rate of its lowest charge on
the ground that contributors should
not be asked to pay in their gifts for
care of needy persons at a higher rate
than the hospital itself charges pay pa
tients. Moreover. no person IN actual
need Is inconvenienced by this plan, for
the hospital, upon evidence of need. can
make any reduced rate which seems
fair to that particular patient, with the
Chest making UP the difference between
the hospitals regular charge Of ward
care and what the patient can afford
to pay.
to be paid by the Community Chest,
member hospitals submit monthly re
quests for reimbursement accompanied
by list of patients cared for during
the preceding month who are eligible
for aid by. Community Chest con-
tributors. This list shows the number
of patient days for each patient by
name, his residence, the amount
charged the patient and the amount
of additional payment asked OF the
Chest.
Persons Eligible for Care.
"Those persons who are eligible for
care with reimbursement by the Com
munity Chest for impatient care are
first, residents of the District Of Co.
Nt,n NJ Trrt14
minimum charge for hospital care IN
open wards; and second, non-resldents
dn emergency only who are unaple 10
pay this minimum charge.
Private patients are not eligible Tor
this aid unless the physicians services
are given gratuitously. Ordinarily pa
tients whose care Is financed by contrl-
buttons to the Community Chest are at
tended by the regular hospital stan
without compensation for their services,
as has been the general practice in
hospitals in the past.
1T is expected that INDECENT patients
who are eligible for admission to
Gallinger Municipal Hospital will be
transferred to that hospital when prac-
ticable to be cared for at Government
expense, rather than be made charge
on limited Community Chest funds.
mo payment is to be made to hos
pitfalls by the Community Chest for COM
pensation cases or other cases handled
under contract with insurance COM
panies, governmental agencies, indus
trial concerns or other organizations.
: Committee to Meet Monthly.
"In addition to this provision for in
patient case, Chest hospitals which have
out patient departments are to be re-
limbursed for the care of such free ane
part pay out-patients as may be eligible
for Community Chest aid at the rate o.