No Strings Attached
Seattle Children’s commitment to uncompensated care helps
families focus on their child’s health rather than the cost of the
medical care needed to restore it.
Lifesaving heart surgeries gave Ansley Hardy, 5, (pictured with mom Marci and brother Marik, 8) a clean bill of health – and her parents never had to
worry about paying their medical bills.
Ansley Hardy’s parents were shocked
to learn that their new baby had a life-threatening
heart condition.
“She didn’t pink up like other
newborns,” remembers Ansley’s mom, Marci Hardy.
Within hours, Ansley and her dad
Blaine Hardy were airlifted from Helena,
Mont., to Seattle Children’s while Marci
recovered from a caesarean section.
The news from Seattle was grim.
“Ansley’s heart wasn’t circulating
oxygenated blood to her body because
the two major vessels that carry blood
away from her heart were switched,”
explains her mom. “She was literally
suffocating to death, but at every step
she just kept pulling through.”
Ansley’s condition, called
transposition of the great vessels,
required three surgeries at Children’s
and hospital stays in Seattle and Helena – care that could have exceeded the
$1 million cap on the family’s healthcare
plan by as much as $500,000.
When a Children’s social worker
suggested they apply for financial assistance, Marci Hardy was reluctant
to ask for help.
123,833 children received uncompensated care in 2011.
“I was a stay-at-home mom, but
Blaine had a good job and we weren’t
poor,” she says.
The social worker convinced the
couple to fill out the application by
asking them if they’d really be able
to absorb any costs their insurance
didn’t pay.
“We were beyond elated and
forever grateful when Children’s sent
us a letter saying we qualified for
financial assistance,” says Ansley’s
mom. “Without it, we might have lost
everything we had, and our parents
and grandparents would have sold everything they had to help us pay our
bill. It would have changed the course
of our life and the lives of our family.”
A worthy promise
The financial assistance specialists at Seattle Children’s serve as touch points for families struggling
with medical bills. “I help families ask the money questions they don’t know to ask or are afraid to
ask,” says Gary Ostendorf, financial counselor.
Since opening our doors in 1907,
we’ve kept our promise to provide all
necessary medical care to kids in our
region – Washington, Alaska, Montana
and Idaho – regardless of a family’s
ability to pay.
In 2011, Children’s picked up the
tab for $103.4 million in care that was
not otherwise paid for.
Approximately $10.7 million of that
total covered unpaid medical services – costs that families incurred for care
beyond their ability to pay.
The rest of the total – a whopping
$92.7 million – covered payment
shortfalls from Medicaid, the
government program that provides
medical coverage at no cost to lowincome
families. Nearly half of our
patients are covered by Medicaid, but
the program reimbursed us for only
71% of the real cost of treatment.
By filling in the gaps left by Medicaid
shortfalls or a family’s inability to pay,
Children’s helps parents focus on what’s
most important – the health and wellbeing
of their child.
Approximately 12% of the $103.4 million
in uncompensated care provided by
Children’s in 2011 came from philanthropic
contributions like the Auction of Washington Wines, an event that
celebrated its 25th anniversary
this summer.
“To have a resource like Children’s
is one of the great blessings of
our community,” says Bob Betz, a
winemaker from Woodinville, Wash.,
who has participated in the auction
since its inception. “The hospital is
dear to my heart and I believe we
have a duty to support the incredible
care that’s available there for any
child in our region who needs it.”
Protecting the piggy bank
Jessie Atkins and daughter Acashia, 10, play with Stage, 6. “Every time someone reaches in their pocket and makes a donation to Children’s, it’s a gift
they’re giving to our family, to our son and to society,” says Atkins.
Jessie Atkins suspected something
wasn’t right when she heard her
son’s cries in the delivery room.
“The nurses and doctors told me
he was fine, but I knew in my heart
something was going on.”
Her intuition was spot on.
Though friends and neighbors
initially passed off concerning symptoms
like poor weight gain, excessive sleep and screaming until blue in the face as colic, Stage was soon diagnosed as
having seizures. At the age of 3 weeks,
he was having up to 15 a day.
When the state medical insurance
that covers moms and babies for the
first year of a child’s life ended, Stage’s
medically fragile condition did not.
Atkins panicked and called Children’s
to cancel all of their appointments,
explaining that she’d reschedule when
she and her husband Jeff could figure
out how to pay.
“A social worker called me back
to find out what was going on,”
remembers Atkins. “I told him I was
overwhelmed and afraid that we’d
lose our house. That’s when he said,
‘Do you know that we have a program
that might be able to help you?’”
For Atkins, Children’s commitment
to providing uncompensated care
means that her family doesn’t have to
choose between paying the mortgage
on their house in Marysville, Wash., and
getting their son the care, prescriptions
and medical supplies he needs – more
than $15,000 a year in costs that their
private insurance doesn’t cover.
“Our son’s fragile health brings so
many worries every day, but we
never worry about receiving a bill
from Children’s.”
Jessie Atkins, mom
“When you have a child like Stage,
people automatically think there are
state services to help,” explains Atkins. “I’m here to tell you, state services
for children are only available for low-income
families. Children’s financial
assistance helps us keep Stage healthy,
put some money away for our daughter’s
college education and hold onto what
little financial security we have.”
A safety net
A childhood of medical care, like that of Casey James (from left, with nurse practitioner Kate Greenleaf and nurse Makayla Ramirez), can cost
well over $2 million. When his insurance co-pays threatened to bankrupt his parents, Children’s
was there to help.
Life is good for Casey James. Now 19
and fresh out of high school in Gig
Harbor, Wash., Casey’s got a good part-time
job, he’s studying video production
at a local technical college, and he’s
doing other things he loves, like hanging
out with his girlfriend and skate-, wake- and
snowboarding with his buddies.
There’s just one thing that sets
Casey apart from his peers: “I wouldn’t
be here today without Children’s.”
Casey was born with posterior
urethral valve (PUV) disorder – a
condition that blocked the normal flow
of urine and left him with a damaged
bladder and only one functioning
kidney.
“I changed jobs to work for a
company that had much better
insurance, because I knew my son
would need lots of care,” explains
Jo James, Casey’s mom.
Initially, her insurance covered all
of Casey’s care. Then the economy
flagged and her company raised the
employees’ co-pay for health insurance
and medical care. And compounding
the issue, the small business owned by
her husband Dave James failed.
Joseph Tutnutmoak, 14, lives in Chevak, Alaska. He suffered acute liver failure in
January 2011 and was airlifted to Seattle Children’s – 2,000 miles away – for a transplant.
Medicaid covered 71% of his care; Children’s picked up the rest.
“A 15% co-pay may not sound like
much to someone who doesn’t often
need medical care,” says James. “But
Casey’s care runs anywhere between
$10,000 to $15,000 per month. With
Dave out of work, we just couldn’t
keep up.”
When James saw information about
Children’s financial assistance printed
on one of Casey’s bills, she picked up
the phone.
“We were on the brink of financial
ruin and now we don’t even see a
Children’s bill,” notes James. “Children’s
pays the 15% co-pay that we’re not able
to cover. I can’t tell you how wonderful
that is.”
Published in Connection magazine, December 2012