Pope pushes Catholic hospitals, clinics to do more to help poor

WASHINGTON — Pope Francis urged a joint session of Congress Thursday to remember "all those people around us who are trapped in a cycle of poverty," a message one hospital CEO in the gallery particularly says he took to heart.

Anthony Tersigni, CEO of the Catholic health system Ascension, already gives incentives to the leaders of his company's hospitals and clinics to provide more uncompensated charity care each year. Ascension, based in St. Louis, is the largest Catholic hospital system in the world and the largest non-profit health system in the USA,

Tersigni, who chairs the International Association of Catholic Hospitals, will meet with Francis in the Vatican in November to discuss the pope's push to get Catholic-owned health care providers to do more to help the poor.

"He would like to see the Catholic Church become more of a missionary church that includes all people, with the poor at the center," Tersigni said with week. "He's challenged us to focus on faith over ideology."

Tersigni said he hopes Francis' repeated references to “the common good” - the need for all of us to think differently about how we care for one another - should motivate all healthcare providers to "think even more creatively and intentionally about how to provide care for those people who need it most."

For the fiscal year ended June 30, Ascension provided nearly $2 billion in charity care, a 7% increase from the previous year and totalling nearly 10% of patient revenue.

Lois Uttley, director of MergerWatch Project, which tracks secular-religious hospital mergers, acknowledged Catholic hospitals provide lots of care for the poor, especially given that there are so many of them. But she said the level of charity care is about the same as most other types of hospitals and less than publicly owned hospitals. According to a December 2013 report by her group at the American Civil Liberties Union, 2.8% of total patient revenue for Catholic non-profit hospitals in 2011 went to charity care, compared with 5.6% for public hospitals.

"We admire this pope's spirit of compassion and call for service to those in desperate circumstances, but we don't believe that spirit is reflected in the religious restrictions that cause some Catholic hospitals to deny care to women suffering reproductive health emergencies,"  Uttley said. "We don't believe it's reflected in the policy of denying tubal ligations to women whose future health would be endangered by additional pregnancies."

There are 645 Catholic hospitals across the nation, according to the Catholic Health Association of the United States, which says about one in six U.S. patients is cared for in a Catholic hospital. About two-thirds of these hospitals are in metropolitan areas, and about one-third are in rural areas, the association says.

Their numbers have been on the rise for years. The 2013 report found the number of Catholic-sponsored or affiliated acute care hospitals rose by 16% from 2000 to 2011, while the numbers of other types of non-profit hospitals declined.

That growth has raised some concern about the influence Catholic institutions have in the provision of services, including birth control, end-of-life care and childbirth when the mother’s life is in danger.

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"We're not going to allow someone to die," Tersigni said of mothers in childbirth. "We’re going to take care of them."

Catholic health directives forbid certain services, including elective abortions, sterilizations, contraceptive dispensing, artificial insemination, in-vitro fertilization and euthanasia. One directive says an institution won’t honor a living will contrary to Catholic teaching, which is open to interpretation.

"The trend of expansion by Catholic health systems has continued and in some cases is leaving communities with only a Catholic hospital — and thus restricted reproductive health care," Uttley said.

Still, Ascension has increased its charity care every year since the company was created in 1999.

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Communities, Uttley said, shouldn't have to "sacrifice access to key reproductive health services in order to protect service to the poor. People should have both."

In the spirit of the Affordable Care Act's push for more efficient health care, Ascension works closely  with primary care providers and clinics in and outside of its network to coordinate care. That effort  makes it easier for Ascension to refer patients with needs that conflict with its Catholic mission to other facilities.

There has been such a decline in city, county and state services available that religious and other groups had to step up to fill the void.

Tersigni called the Affordable Care Act a "health care financing policy."

"We’ve never as a nation decided on a health policy," he said. "How do we prevent them from falling through the cracks?"

In May, Tersigni raised the company's minimum wage to $11 an hour. Senior managers  subsidize a percentage of the benefits provided to lower-income workers, he said.

Tersigni noted that the company's mission statement doesn't even include the word "health," it states that the company is made up of advocates for a "compassionate and just society."

Tersigni cites Francis' remarks to Congress when he said, "the fight against poverty and hunger must be fought constantly and on many fronts, especially in its causes." Tersigni says Ascension hopes to keep increasing its charity care and programs that benefit communities and reduce poverty. .

"It’s our mission, and it really is at the heart of all we do," he says.