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Commission adopts patient-rate increases; San Francisco City Clinic set a $25 flat fee as placeholder
Summary
The commission approved a patient-rates ordinance that raises patient charges at San Francisco General and Laguna Honda by 7%, introduces two public-health-lab Medicare-rate lines and includes a $25 flat fee for the San Francisco City Clinic with provisions for waivers; commissioners asked staff to ensure fees would not deter clients and to provide waiver procedures.
The Department of Public Health commission voted to approve the annual patient-rates ordinance accompanying the mayor—s proposed budget, a package that includes a general 7% increase for patient rates at San Francisco General and Laguna Honda and changes to billing rules for several public-health services.
"This year, the patient rates at San Francisco General and Laguna Honda are increasing by 7%," the presenter said, explaining the change is tied to updated cost reports and an effort to maximize Medi-Cal and other reimbursements. The presenter noted that day services and outpatient rates rose substantially because those services— reported higher actual costs.
The ordinance also establishes two new public-health-lab rates at a Medicare level and proposes a $25 flat fee for services at the San Francisco City Clinic, replacing the prior voluntary $10 donation. Staff explained the $25 fee is intended as a placeholder to encourage patients to provide insurance information so the department can bill insurers when appropriate; clinic staff said waivers will be available for public-health reasons or inability to pay.
Commissioners asked for details about how the fee would be implemented and whether it could discourage clinic utilization. Finance staff and the presenter (Greg Wagner, chief financial officer) said behavioral-health patients will continue to have options to waive fees and that the City Clinic will include provisions to waive the $25 fee where clinically appropriate.
The commission approved the rates by voice vote. Staff committed to provide commissioners with a clearer cost-to-charge history and a breakdown of which rate categories drive reimbursement outcomes going forward.
