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Health Commission approves DPH patient-rates update after Deloitte benchmarking; ordinance raises revenue by about $2.63M
Summary
The commission approved a proposed update to the Department of Public Health's charge master, following a Deloitte peer benchmarking study; some rate changes will be phased in and the proposal is estimated to increase revenue by about $2,630,000 versus the prior rates ordinance.
Greg Wagner (DPH) presented a proposed update to the department's patient charge master, explaining that Deloitte Consulting benchmarked DPH rates against 15 peer hospitals and recommended adjustments to bring many rates closer to the 75th percentile for Northern California to account for the city's higher cost environment.
Wagner reiterated protections DPH adopted previously to limit balance billing: commercially insured patients are charged in-network cost sharing rather than out-of-network full charges, and income-tiered out-of-pocket caps are available to patients. He described two categories (emergency-department and trauma-activation charges) proposed for phased implementation over three to five years to avoid immediate financial pressure during the COVID-19 response.
Commissioners asked technical and clerical questions (one ordinance table contained a numeric transposition that staff acknowledged and agreed to correct). Commissioner Green moved to approve the ordinance and the motion carried on a roll-call vote.
Wagner said the combined rate adjustments would increase DPH revenue by about $2,630,000 relative to the last approved rates ordinance; commissioners asked for clarification about impacts to services and to patients, and staff noted the department's prior work to reduce balance-billing risk for patients.
