Aug. 17--As one of Montana's largest hospital providers of charity medical care and other programs that don't always turn a profit, St. Vincent Healthcare of Billings is committed to keeping it surrounding community healthy, its officials said Thursday.

Yet they're also concerned about the growing number of people without health insurance, after several years of a struggling economy, said Tracy Neary, director of mission outreach and community benefit for St. Vincent.

"The financial assistance we have provided to patients has doubled in the last two years and is four times what it was five years ago," she said.

Neary and other hospitals' officials reacted Thursday to the attorney general's fifth annual report on Montana hospitals' "community benefits," which, as nonprofit, tax-exempt organizations, they're supposed to provide.

The report said community benefits reported by the state's 22 largest hospitals increased 17.5 percent in fiscal 2010.

Yet the report said the category that made up most of the increase -- "subsidized health services" -- had some questionable entries, and that some hospitals had overstated their amounts.

Subsidized services are supposed to be unavailable elsewhere in the community, and be provided at a loss to the hospital. They can include emergency services, primary-care clinics, mental health treatment and kidney dialysis.

The report questioned why some hospitals reported in-town physician clinics as "subsidized," saying the category usually applies to clinics in outlying communities.

Two hospitals that listed big-dollar benefits for in-town clinics -- St. Peter's in Helena and Community Medical Center in Missoula -- defended their reporting on Thursday.

St. Peter's considers its local physicians' group a subsidized service because the "vast majority" of its physicians wouldn't be in the community without the hospital employing them, said spokeswoman Peggy Stebbins. The hospital reported $5 million in subsidized services for its clinic.

Community considers its clinics -- one of which is in Stevensville -- a subsidized service because they accept all patients, regardless of cost, and the hospital essentially subsidizes the cost of physicians providing those services, said Mary Windecker, vice president of planning and marketing.

Community reported $4.3 million in subsidized services for its clinics.

The 2010 increases in charity care came primarily at Montana's largest hospitals, but they also reported $65 million in subsidized services -- about 40 percent of all community benefits.

Kristianne Wilson, executive director for health policy at Billings Clinic, said it locates its subsidized clinics where there is a shortage of primary care, such as Red Lodge, Columbus and Miles City.

She added that Billings Clinic has been voluntarily reporting its community benefits since 1996, and is proud of its commitment to the community.

"I feel very good about the amount of charity care (we provide) and, even more importantly, the process to ensure that people who don't have the resources to pay for their health care are given the opportunity to get financial assistance," she said.

Billings Clinic provided $13.6 million in charity care in 2010; St. Vincent was second at $12.4 million.

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