Uncompensated Care

Scripps contributes significant resources to low- and no-cost health services to populations in need. In fiscal year 2016, Scripps devoted $335 million to providing uncompensated care. “Uncompensated health care” includes:

  • Charity care

Free and discounted inpatient and outpatient care to persons who meet our organization’s financial assistance policies.

  • Bad debt

Unpaid costs for care that are provided to persons who do not meet the criteria for charity care, are not covered by a third-party payer or have a co-payment obligation that is not met.

  • Under-reimbursed care

Care that is reimbursed below cost by third-party payers.

To learn more, view the 2017 Community Benefit Report. (PDF, 11 MB)

Financial assistance

The Scripps financial assistance policy reflects our commitment to assisting low-income, uninsured patients with discounted hospital charges, charity care, billing and collection practices. Our program is provided without regard to race, ethnicity, gender, religion or national origin. Learn more about financial assistance in our patient guide.

Free retinal screening program

Ricardo Hernandez has lived with diabetes for more than seven years. During that time, the 43-year-old National City resident has seen deterioration in his eyesight as a result of the disease. Deeply concerned that he would permanently lose his vision, he learned about a free retinal screening program offered at a nearby community clinic, which was supported by Scripps Whittier Diabetes Institute.

When ophthalmologist Paul Tornambe, MD, and George Hayes, manager of the Scripps Mobile Medical Unit, met Ricardo, they recognized the urgency of his situation. Ricardo had severe retinopathy and clinically significant macular edema, which if left untreated, would lead to blindness.

“Ricardo had a massive hemorrhage in his right eye and his left eye was also bleeding,” says Dr. Tornambe. "We immediately began care; first, with injections of a medication to shrink the blood vessels in the eyes, and then with laser treatments in an effort to stop the bleeding.”

Dr. Tornambe, a great champion for the prevention and early treatment of diabetic retinopathy, has been volunteering at the weekly clinic for five years. Retinal photographs of patients are taken aboard the Scripps mobile medical unit and then Dr. Tornambe is able to interpret the screenings and recommend any follow-up care. More than 100 patients, many suffering from vision complications as a result of their diabetes, receive retinal screenings each month.

San Diego rescue mission partnership

In partnership with the San Diego Rescue Mission, the Scripps Recuperative Care Program (RCU) provides safe discharge, placement services and resources for unfunded or underfunded, chronically homeless patients with ongoing medical needs. Last year, the program served 68 patients who had a cumulative total of 1,518 hospital days of stay before going to the RCU.

The program provides 24-hour supervision, medication monitoring, RN case management oversight with physician backup, meals, clothing and counseling, as well as assistance with permanent housing and county medical services, Medi-Cal and disability applications. All patients are connected with a medical home in the community, and patients with psychiatric disorders are established with a community psychiatrist.

Advocating for those in need of health care

Thousands of uninsured patients in San Diego are eligible, though not enrolled in, government-assisted medical benefits. Without insurance to provide for preventive and routine care, these individuals often rely on costly emergency services for health care.

Since 1999, the Consumer Center for Health Education and Advocacy, a project of the Legal Aid Society of San Diego, Inc., has helped tens of thousands of San Diegans obtain health care.

The consumer center helps low-income, uninsured patients from Mercy Clinic, other Scripps hospitals and Scripps Mercy, and behavioral health patients (including the homeless) who need assistance obtaining health care benefits, Supplemental Security Income benefits and related services.

In addition to providing this vital community service, the program reduces uncompensated care expenses for Scripps.

Caring beyond the clinical setting

Scripps’ commitment to the community expands beyond clinical care. We also are dedicated to helping patients thrive after discharge, even under challenging circumstances. Last year, Scripps awarded a grant to Catholic Charities to provide short-term emergency shelter for medically fragile homeless patients being discharged from Scripps Mercy Hospital San Diego and Chula Vista.

These patients, who no longer require hospital care, but still need a supportive environment, receive case management and one week in a hotel, along with food and bus fare to pursue their care plan. Case managers help them connect to more permanent sources of income and housing, and provide ongoing support. Ultimately, the partnership aims to reduce the number of return visits to the emergency department and improve quality of life for these patients.

Ensuring access to behavioral health care

With the expansion of Medi-Cal and Covered California, significantly more individuals are seeking behavioral health care. To help meet that need, Scripps Mercy Hospital is partnering with Family Health Centers of San Diego (FHCSD) to strengthen behavioral health services in the community and ensure patients receive timely access to care before their health status becomes critical. The goal is to provide proactive, comprehensive care to reduce the probability of hospitalization. 

If a shared patient is admitted, Scripps Mercy and Family Health Centers will help ensure a seamless transition of care at discharge into appropriate outpatient care, preventing a return to the emergency department. Thanks to a longstanding focus on integrating behavioral health into primary care, community clinics have developed considerable in-house resources and expertise to deal with mild to moderate behavioral health issues.

For example, since late 2000, every primary care visit at FHCSD has included a mental health screening, and FHCSD clinics now see between 180 and 225 patients daily for in-person mental health visits.