Helping Parents Focus on Their Child’s Care, Not How to Pay for It

No Strings Attached

Seattle Children’s commitment to uncompensated care helpsfamilies focus on their child’s health rather than the cost of themedical care needed to restore it.

Hardy family

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 toworry about paying their medical bills.

Ansley Hardy’s parents were shockedto learn that their new baby had a life-threateningheart condition.

“She didn’t pink up like othernewborns,” remembers Ansley’s mom, Marci Hardy.

Within hours, Ansley and her dadBlaine Hardy were airlifted from Helena,Mont., to Seattle Children’s while Marcirecovered from a caesarean section.

The news from Seattle was grim.

“Ansley’s heart wasn’t circulatingoxygenated blood to her body becausethe two major vessels that carry bloodaway from her heart were switched,”explains her mom. “She was literallysuffocating to death, but at every stepshe just kept pulling through.”

Ansley’s condition, calledtransposition of the great vessels,required three surgeries at Children’sand hospital stays in Seattle and Helena – care that could have exceeded the $1 million cap on the family’s healthcareplan by as much as $500,000.

When a Children’s social workersuggested they apply for financial assistance, Marci Hardy was reluctantto ask for help.

123,833 children received uncompensated care in 2011.

“I was a stay-at-home mom, butBlaine had a good job and we weren’tpoor,” she says.

The social worker convinced thecouple to fill out the application byasking them if they’d really be ableto absorb any costs their insurancedidn’t pay.

“We were beyond elated andforever grateful when Children’s sentus a letter saying we qualified forfinancial assistance,” says Ansley’smom. “Without it, we might have losteverything we had, and our parentsand grandparents would have sold everything they had to help us pay ourbill. It would have changed the courseof our life and the lives of our family.”

A worthy promise

Gary Ostendorf

The financial assistance specialists at Seattle Children’s serve as touch points for families strugglingwith medical bills. “I help families ask the money questions they don’t know to ask or are afraid toask,” says Gary Ostendorf, financial counselor.

Since opening our doors in 1907,we’ve kept our promise to provide allnecessary medical care to kids in ourregion – Washington, Alaska, Montanaand Idaho – regardless of a family’sability to pay.

In 2011, Children’s picked up thetab for $103.4 million in care that wasnot otherwise paid for.

Approximately $10.7 million of thattotal covered unpaid medical services – costs that families incurred for carebeyond their ability to pay.

The rest of the total – a whopping $92.7 million – covered paymentshortfalls from Medicaid, thegovernment program that providesmedical coverage at no cost to lowincomefamilies. Nearly half of ourpatients are covered by Medicaid, butthe program reimbursed us for only71% of the real cost of treatment.

By filling in the gaps left by Medicaidshortfalls or a family’s inability to pay,Children’s helps parents focus on what’smost important – the health and wellbeingof their child.

Approximately 12% of the $103.4 millionin uncompensated care provided byChildren’s in 2011 came from philanthropiccontributions like the Auction of Washington Wines, an event thatcelebrated its 25th anniversarythis summer.

“To have a resource like Children’sis one of the great blessings ofour community,” says Bob Betz, awinemaker from Woodinville, Wash.,who has participated in the auctionsince its inception. “The hospital isdear to my heart and I believe wehave a duty to support the incrediblecare that’s available there for anychild in our region who needs it.”

Protecting the piggy bank

Atkins family

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 giftthey’re giving to our family, to our son and to society,” says Atkins.

Jessie Atkins suspected somethingwasn’t right when she heard herson’s cries in the delivery room.

“The nurses and doctors told mehe was fine, but I knew in my heartsomething was going on.”

Her intuition was spot on.

Though friends and neighborsinitially passed off concerning symptomslike poor weight gain, excessive sleep and screaming until blue in the face as colic, Stage was soon diagnosed ashaving seizures. At the age of 3 weeks,he was having up to 15 a day.

When the state medical insurancethat covers moms and babies for thefirst year of a child’s life ended, Stage’smedically fragile condition did not.

Atkins panicked and called Children’sto cancel all of their appointments,explaining that she’d reschedule whenshe and her husband Jeff could figureout how to pay.

“A social worker called me backto find out what was going on,”remembers Atkins. “I told him I wasoverwhelmed and afraid that we’dlose our house. That’s when he said,‘Do you know that we have a programthat might be able to help you?’”

For Atkins, Children’s commitmentto providing uncompensated caremeans that her family doesn’t have tochoose between paying the mortgageon their house in Marysville, Wash., andgetting their son the care, prescriptionsand medical supplies he needs – morethan $15,000 a year in costs that theirprivate insurance doesn’t cover.

“Our son’s fragile health brings somany worries every day, but wenever worry about receiving a billfrom Children’s.”

Jessie Atkins, mom

“When you have a child like Stage,people automatically think there arestate services to help,” explains Atkins. “I’m here to tell you, state servicesfor children are only available for low-incomefamilies. Children’s financialassistance helps us keep Stage healthy,put some money away for our daughter’scollege education and hold onto whatlittle financial security we have.”

A safety net

Casey James

A childhood of medical care, like that of Casey James (from left, with nurse practitioner Kate Greenleaf and nurse Makayla Ramirez), can costwell over $2 million. When his insurance co-pays threatened to bankrupt his parents, Children’swas there to help.

Life is good for Casey James. Now 19and fresh out of high school in GigHarbor, Wash., Casey’s got a good part-timejob, he’s studying video productionat a local technical college, and he’sdoing other things he loves, like hangingout with his girlfriend and skate-, wake- andsnowboarding with his buddies.

There’s just one thing that setsCasey apart from his peers: “I wouldn’tbe here today without Children’s.”

Casey was born with posteriorurethral valve (PUV) disorder – acondition that blocked the normal flowof urine and left him with a damagedbladder and only one functioningkidney.

“I changed jobs to work for acompany that had much betterinsurance, because I knew my sonwould need lots of care,” explainsJo James, Casey’s mom.

Initially, her insurance covered allof Casey’s care. Then the economyflagged and her company raised theemployees’ co-pay for health insuranceand medical care. And compoundingthe issue, the small business owned byher husband Dave James failed.

Joseph Tutnutmoak

Joseph Tutnutmoak, 14, lives in Chevak, Alaska. He suffered acute liver failure inJanuary 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 likemuch to someone who doesn’t oftenneed medical care,” says James. “ButCasey’s care runs anywhere between $10,000 to $15,000 per month. WithDave out of work, we just couldn’tkeep up.”

When James saw information aboutChildren’s financial assistance printedon one of Casey’s bills, she picked upthe phone.

“We were on the brink of financialruin and now we don’t even see aChildren’s bill,” notes James. “Children’spays the 15% co-pay that we’re not ableto cover. I can’t tell you how wonderfulthat is.”

Published in Connection magazine, December 2012