College campuses nationwide are witnessing a crisis in their health clinics. The post-pandemic surge in demand for crucial health services, combined with staffing shortages and budget cuts, has left numerous on-campus clinics struggling to operate at full capacity.
The University of Portland’s Student Health Center (SHC) is no anomaly.
According to Kaylin Soldat, director of the UP’s SHC, the demand for services has increased exponentially.
“Years ago, students just went to the Student Health Center when they had a cold or they scraped their knee or maybe sprained an ankle, so it was fairly simple care,” Soldat said. “Now, we act as the actual primary care for many students.”
To address the rising operational costs, the SHC will begin accepting most major insurance plans as a form of payment for medical services starting in January. Mental health services, funded by the $120 Wellness Fee that students pay each semester, will continue to remain free.
According to Tamara Herdener, the associate vice president for student development and dean of students, the revenue generated by the insurance payments will be routed from the UP’s general fund and be used to cover some of the expenses of the health center.
“We are hoping to bring in like $150,000 of revenue in one year,” Herdener said. “It [the revenue] could be to cover supplies, it could be to cover linens, you know we have front desk people, just the rising cost of the health center.”
The SHC will be outsourcing its billing to Efficient Medical Billing Services, a third-party company. According to Herdener, it is less expensive to outsource the billing, rather than handling it internally.
Before implementing this billing change, the center relied on the combination of the student health fee and individual charges for tangible items like lab testing, medications or procedures to support its operational expenses.
“We didn’t have the ability to bill insurance, so that [the cost of services] would be charged to the student directly,” Soldat said.
Now, Herdener and Soldat are optimistic that accepting students' existing insurance will enable the SHC to maintain full operational capacity and uphold its current range of services.
Graphic by Julianna Pedone.
“All of our students on campus have insurance,” Soldat said. “Unfortunately, providing health care is really expensive. By changing our model to one that is actually working with insurance companies we will be able to continue to provide comprehensive primary care services on campus versus having to potentially pull back on what we’re able to offer.”
The viability of the new billing process was investigated by Soldat and Herdener through an assessment of successful billing models employed by health centers at other universities.
“Kaylin [Soldat] went over to Pacific University which has a really robust and really well running insurance billing program in their health center,” Herdener said. “And [she] visited with some other universities, Oregon State University, University of Oregon, and even some schools that are Catholic and small around the country.”
Despite the change in billing policy, Herdener reiterates that the services offered and the standard of care at the SHC will not be negatively affected.
“I want to reassure them [students] that they will have continued access to excellent primary care,” Herdener said. “I’m really grateful to our staff over at the Student Health Center for their work with students.”
While the SHC has successfully contracted with many major insurance companies including United Healthcare, Providence and Cigna, there are a few major insurance providers that the SHC cannot accept.
“Kaiser won’t contract with us,” Herdener said. “We’ve tried so hard and we’ve been trying for months. And it’s not uncommon for Kaiser to not contract with small clinics like ours because they want people to come to their clinic.”
Students whose health insurance company is out-of-network are still able to be seen at the SHC, and will receive a bill for the full cost of their visit. This bill can be sent to a student’s insurance company for possible reimbursement.
If the cost of service at the SHC is too high, the SHC can assist a student with finding more affordable care with an in-network off campus.
“Medical billing is really complex,” Soldat said in a followup email to The Beacon. “Health insurance companies decide how much they will pay clinics for services and how much a student will be responsible for. Two students receiving the same services at the SHC may end up paying different amounts depending on their insurance plan.”
Soldat acknowledges that this change may raise financial concerns within the UP community. However, she is steadfast in her belief that this transition is in the SHC’s — and students’ — best interests.
“In the long-term it will mean more robust, comprehensive services will continue to be available to students,” Soldat said in a followup email to The Beacon. “As long as we’re in network with your insurance company, we will almost certainly be the least expensive option for care in the community.”
If students have any questions regarding the change in billing, they can visit Student Health Center FAQs for more information. Soldat also implores any students who are apprehensive to call the SHC with any inquiries they may have.
“We don’t want students to avoid seeking care because they are worried about the cost,” Soldat said. “We are here to support them and help them find the best health option for them, and that includes being transparent with pricing.”
Students who wish to maintain confidentiality regarding the services they receive at the SHC must submit a request for confidential communication to their insurance company. This request may take up to 30 days to process, so students are encouraged to submit it as early as possible
Soldat emphasizes that the SHC is a safe place for all students, where student privacy is one of the utmost priorities. Free services such as STI and pregnancy testing, which will continue to be provided with utmost discretion.
“We [the SHC staff] genuinely care about the students. We all do,” Soldat said. “That’s why we are here. And so we just want safe, accessible resources for them.”
Herdener believes that while there will be a shift in the SHC's billing process, the level of value it provides to students remains unchanged.
“I really, really encourage students to use the health center because it is just accessible,” Herdener said. “They’re very caring, very loving people. And it's just a way for us to keep our students healthy and safe.”
Julianna Pedone is a reporter for The Beacon. She can be reached at pedone25@up.edu.
