Proposal To Restrict No-Cost Care at Atlanta Public Hospital Draws Criticism From Patient Advocates

A proposal that would restrict the amount of no-cost care that some uninsured patients could receive at Grady Memorial Hospital, a financially troubled public hospital in Atlanta, has raised concerns among patient advocates, the Atlanta Journal-Constitution reports. The "Grady Card" discount program offers subsidized or no-cost care to uninsured area residents. The Journal-Constitution obtained documents about the proposed changes under Georgia's open records law.

Under the current rules of the discount program, patients from Fulton and DeKalb counties with annual incomes up to 250% of the federal poverty level are eligible for no-cost care. Patients with similar income levels from other counties are required to pay 30% of their medical bills. The program currently serves about 250,000 people. Under the proposed changes, patients from Fulton and DeKalb counties with annual incomes of between 126% and 200% of the poverty level would be expected to pay up to 40% of their medical bills and patients from other counties would have to pay up to 70% of their bills. Residents of the two counties with annual incomes up to 125% of the poverty level still would be eligible for no-cost care, while patients from other counties would be eligible for a maximum discount of 50%. The expenses for patients needing costly medical procedures would be capped and dependent on their income.

According to the New Grady Coalition, the proposal could lead some patients to forgo essential care. Leaders of the advocacy group say that proposal reneges on a promise made by hospital officials in early 2008 to continue the system's mission as a safety net hospital for low-income residents.

Hospital officials said they proposed changes to the Grady Card discount program because it has been abused by some patients who can afford to pay a portion of their care costs. The hospital's board was scheduled to meet on Monday to discuss the proposal, but no final vote was expected, officials said. Hospital CEO Michael Young said that the hospital already has begun to closely screen its patients' finances and in December 2008, issued notices to 1,400 patients who were identified as being ineligible for discounted care. He said that the hospital would not turn away patients who need essential care, adding that the hospitals is "having a dialogue" with advocates and community leaders (Schneider, Atlanta Journal-Constitution, 1/1).