UCHealth needs more money and support to keep responding to the surge in migrants arriving in metro Denver, the health system’s leaders are warning after University of Colorado Hospital provided $10 million in uncompensated care in just three months.

Health care workers want to help, but hospitals can’t keep providing this level of uncompensated care, let alone meet migrant patients’ full needs, said Dr. Richard Zane, an emergency medicine physician and UCHealth’s chief innovation officer. UCHealth needs to receive reimbursement and to have somewhere to refer patients for housing and other supports, he said.

“It is not sustainable,” Zane said.

In January, Denver Health reported its recovering finances would be in danger again this year if the safety-net hospital didn’t receive more funding to care for migrants arriving with no insurance and little money. Other Colorado hospital systems say they’re facing a similar challenge, though most have more financial cushion.

UCHealth estimated its other hospitals provided about $7 million in uncompensated care to people it identified as likely migrants between November and January, on top of the $10 million provided at the University of Colorado Hospital campus in Aurora. The hospitals don’t ask patients about their immigration status, but compiled data about care given to people who don’t have a Social Security number or health insurance.

About 5,800 patients who fell into that category received emergency, inpatient or outpatient care there for the first time during those three months, according to UCHealth. That figure doesn’t include immigrants who had sought care from the system before, or those who qualified for emergency Medicaid, which covers undocumented patients in labor and those with some life-threatening conditions.

The true numbers may be higher, and they don’t fully capture the impact of so many people with complex health problems arriving in a short window, Zane said. Many migrants have chronic conditions that they couldn’t treat on their journey to the United States and trauma from being trafficked or abused in their home countries or on the way, he said. Others have simpler needs, like routine vaccinations or obstetrical care, which are complicated by their lack of resources.

People who recently arrived and don’t have legal permission to work are struggling with homelessness, lack of transportation, inability to pay for medical care and lack of access to nutritious food, and they may not know what city they’ll be living in a few months from now, Zane said. In some cases, even following up with patients’ test results is a challenge, because they may not have a place to charge their phones, he said.

UCHealth brought on additional providers, social workers, care coordinators and others to help meet the demand, but getting people housed and insured is beyond the health system’s capabilities, Zane said.

“It’s a societal responsibility; it’s not just a hospital responsibility,” he said.

The city of Denver estimated more than 38,000 migrants have arrived since December 2022, and about half opted to stay in the area.  Most are Venezuelans fleeing a humanitarian crisis, according to the city.

Denver Health reported in January that about 8,000 people from Central America had made a combined 20,000 visits in 2023. It estimated those patients needed about $10 million in care the hospital didn’t get paid to deliver. The total could include some people who were in Denver for other reasons and miss migrants from other parts of the world.

Hospitals vary in what they charge for care, so the same procedure performed without pay at two facilities may yield different levels of uncompensated care, and some hospitals may be performing more complicated, and expensive, procedures than others. In addition, some may be more comprehensive than others in calculating their estimates.

Tracking how many patients are recent arrivals from overseas can be challenging, because people aren’t always comfortable talking about their immigration status, said Cara Welch, spokeswoman for the Colorado Hospital Association. Electronic medical records don’t have a box to specify how long a person has been in the country, so collecting data on all foreign-born people could mislabel long-standing immigrant communities, she said.

Banner Health, which owns five Colorado hospitals, including McKee Medical Center in Loveland, said it couldn’t break down its charity care costs by immigration status. Intermountain Health, which owns Saint Joseph Hospital in Denver and Lutheran Medical Center in Wheat Ridge, among others, said the same.

AdventHealth, which owns the Adventist hospitals in the Denver area, said it also wasn’t certain how many recent immigrants its Colorado hospitals treated, but the steady stream of new arrivals likely contributed to its 31% increase in charity care from November to January, compared to the previous year.

HealthOne estimated inpatient stays by undocumented people increased more than six-fold at its Colorado hospitals from 2022 to 2023, but couldn’t say how many patients it treated in that time.

“Our care teams continue to provide skilled, compassionate care during these visits and work to identify community resources to aid in follow-up care when appropriate,” spokeswoman Stephanie Sullivan said.

Caring for new arrivals is doubly challenging because almost none have medical records with them, UCHealth’s Zane said. That means providers have to start from scratch and run more tests to figure out what’s ailing the patient, let alone how to help them, he said.

“Someone who has complex medical conditions, it’s highly unlikely they know the history of the care they’ve received,” he said.

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