Comparing Uncompensated Care

The UNC Health Care System, and Rex Healthcare in particular, have been unfairly criticized about the amount of uncompensated care we provide in Wake County. (Uncompensated care is the cost of care for which we are not paid).

Specifically, WakeMed CEO Bill Atkinson has said that WakeMed provides more than its fair share of the uncompensated care in Wake County and that Rex Healthcare needs to provide more. This is false.

Rex Healthcare is a community hospital, integrated into the UNC Health Care System. Similarly, WakeMed Cary is a community hospital affiliated with the WakeMed system. That’s why it makes more sense to compare apples to apples – and parent hospital to parent hospital and affiliated community hospital to affiliated community hospital.

We know that the UNC Health Care System provides significantly more uncompensated care than WakeMed’s system – $309 million to $162.4 million, respectively in fiscal year 2010. And we know that Rex Healthcare provided $85.2 million in fiscal year 2010. But we don’t know how much uncompensated care is broken down within the WakeMed system. Since fiscal year 2008, WakeMed has elected not to submit data for WakeMed Cary to the North Carolina Hospital Association for charity or community benefits – instead rolling up WakeMed Cary’s data into the larger WakeMed total.

While WakeMed’s lack of transparency keeps us from comparing dollar amounts spent on charity care, we can look at some of the patient data. According to state licensure records, WakeMed Cary has fewer uncompensated patients than Rex. Approximately 10 percent of Rex’s outpatient visits are uncompensated, while only 3 percent of WakeMed Cary’s outpatient visits are uncompensated. On any given day in the emergency department, Rex sees an average of 50 percent more uncompensated care patients than WakeMed Cary. Even after factoring in size, WakeMed Cary sees fewer uncompensated care patients than Rex does.

Given the opportunity, we’d welcome the chance to conduct a more comprehensive comparison of uncompensated care at WakeMed Cary and Rex Healthcare, or of UNC Hospitals to WakeMed. All entities affiliated with UNC Health Care will continue to provide our standard excellent care to all patients who walk through our doors, regardless of their ability to pay.

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