Zuckerberg hospital is out of network with all private insurers, leaving patients with massive bills

Morgan Haefner - Print  | 

Zuckerberg San Francisco General's decision to remain out of network with all private health plans can cost policyholders tens of thousands of dollars through balance billing, according to a Vox investigation.

Here are five things to know:

1. Zuckerberg San Francisco General, which underwent a name change after Facebook founder Mark Zuckerberg and his wife Priscilla Chan, MD, donated $75 million to the hospital, is the city's largest public hospital and houses San Francisco's only top-tier trauma center.

2. However, privately insured patients brought to the hospital's emergency room, either by ambulance or another form of transportation, often pay significantly more for the services they receive at Zuckerberg than they would if they went to another hospital, according to Vox.

3. That's because while most large hospital ERs negotiate prices for services with private health plans, Zuckerberg isn't in network with any private health plans — subjecting many patients to balance billing practices.

4. A Zuckerberg hospital spokesperson confirmed with Vox it doesn't network with any private health insurer, and said the practice is normal.

"It's a pretty common thing," spokesperson Brent Andrew told Vox. "We're the trauma center for the whole city. Our mission is to serve people who are underserved because of their financial needs. We have to be attuned to that population."

5. But most billing experts told the publication it's rare for a major hospital like Zuckerberg to be out of network with all private health plans. Nearby trauma centers in Davis, Calif., and Portland, Ore., and most other public trauma centers advertise the private plans they network with on their websites.

"According to what I've seen, that's unusual," Christopher Garmon, PhD, an economist at the University of Missouri Kansas City, told Vox. "I've heard anecdotes of some hospitals trying a strategy like this, but my impression is that it doesn't last very long."

To access the full report, click here.

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