April 11, 2021

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Onerosa patient care | PRESENT


Hospitalization and treatment of coronavirus positive cases (Covid-19) have become an onerous challenge for patients and the health industry, which could have greater repercussions as the admission of infected people in the hospital institutions.

An average cost of $ 20,000 per patient requiring hospitalization, and up to $ 88,000 in those with a more compromised state – and who need a ventilator – is the estimate of a recent study by the Birling Capital firm on the state of the hospital industry before the Covid-19.

As of yesterday, the Health Department had 442 hospitalizations registered for coronavirus, with 56 patients in the intensive care units and 40 of these assisted by the use of ventilators. The number of people positive for Covid-19 was 4,574, probable cases 8,899 and deaths 188.

Armando Rodríguez, president and chief executive officer of HIMA San Pablo, confirmed that amid the challenges hospitals have faced now is when they have begun to feel more directly the impact of attending to the complexities of patients positive for the novel virus and its costs.

“What has rebounded are Covid-19 patients, but unfortunately for this condition they have not there was a contract, it is somewhat atypical, so we have to wait for the real economic impact to the hospital coffers, since the payment cycles are extensive and it may be that some parts are paid to us, but others are not, which generates additional pressure "Rodríguez pointed out.

As the management of the virus has advanced – for which there is no vaccine – the cost estimates for patients have increased. Just over three months ago, the New York-based nonprofit, the Peterson Center on Healthcare, and the Kaiser Family Foundation conducted a study that projected treatment for severe cases of coronavirus at a cost of over $ 20,000. Then they indicated that the out-of-pocket expenses for patients —in deductibles for medical plans— exceeded $ 1,300.

Francisco Rodríguez Castro, president and chief executive officer of Birling Capital, explained that after the recent analysis in Puerto Rico, the cost It is around $ 20,000 for hospitalized patients and $ 88,000 for those who reach serious stages. He said that they are amounts not entirely covered by medical plans.

Insurers react

Iraelia Pernas, executive director of the Association of Insurance Companies (Acodese), acknowledged that Covid- 19 is a new disease that poses broad challenges for everyone, but rejected that patients are not covered.

“Covid-19 is covered like any other condition. Insurers pay per day of hospitalization according to the intensity of the service. Intensive carries a higher cost, "said Pernas, noting that" although these are unforeseen costs, insurers have adjusted and will pay. "

He mentioned that the concern – in patients and hospitals – that there is no quick and fair payment should not exist because providers are protected through the punctual payment law. He explained that this allows a period of 30 days to pay the completed bills in full.

“If this is not complied with, the hospital can file a claim with the Office of the Insurance Commissioner and the insurer would be fined, at the same time he would have to pay interest on the amount owed, "he said.

Pernas commented that in the midst of the emergency and the financial difficulties that the hospitals have claimed, they have received millions of dollars in local and federal aid to meet the incremental costs and losses.

Under continuous observation the health industry

Rodríguez Castro mentioned that the regulations for the health authorities in the care of patients before the Covid-19 —which are now much more rigorous— entail incremental costs in personal protective equipment and disinfection work.

In addition, there are fewer hospital admissions due to fear of s people to come to receive medical attention and treatments.

While Rodríguez, with the second largest hospital group on the Island, explained that 80% of hospital income comes from admissions and 20% from outpatient services, and this has been disrupted by the pandemic. "People are staying in their homes beyond reason for fear of getting it and when they arrive in our emergency rooms, they are already in a very critical situation," he said.

Birling Capital's latest estimate of the coup The financial impact of the emergency caused by the Covid-19 to the hospitals is that they could face losses of close to $ 1 billion by the end of the year.

In the past four months, the losses have already totaled over $ 365 million. indicates that if the current situation continues until December, at least 30 hospitals would have to reduce their operations and about 15 would be forced to close their doors. As of May, the sector had already cut 8,000 jobs.

“Many losses have been covered by local and federal aid, and each hospital has made its adjustments. But every day sicker patients arrive, whose treatments have increased exponentially. We all have to do our part, "said Rodríguez.

Called to protect jobs

The president of the College of Surgeons, Victor Ramos, reiterated that the" emergency "they are experiencing is real private hospitals because of the pandemic, but clarified that the financial part is a situation that dragged several years ago for the little that insurers pay them.

“The situation is difficult, but the census in hospitals is increasing. I don't want to think that the issue of the economic situation is exposed, because they want to justify not bringing back the laid-off employees, "said Ramos.



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