Zuckerberg San Francisco General has arranged for all ER care to be out-of-network, allowing the hospital to charge whatever wild prices it likes.
Zuckerberg San Francisco General (ZSFG), recently renamed for the Facebook founder after he donated $75 million, is the largest public hospital in San Francisco and the city’s only top-tier trauma center. But it doesn’t participate in the networks of any private health insurers — a surprise patients like Dang learn after assuming their coverage includes a trip to a large public ER.
Most big hospital ERs negotiate prices for care with major health insurance providers and are considered “in-network.” Zuckerberg San Francisco General has not done that bargaining with private plans, making them “out-of-network.” That leaves many insured patients footing big bills.
The problem is especially acute for patients like Dang: those who are brought to the hospital by ambulance, still recovering from a trauma and with little ability to research or choose an in-network facility.
A spokesperson for the hospital confirmed that ZSFG does not accept any private health insurance, describing this as a normal billing practice. He said the hospital’s focus is on serving those with public health coverage — even if that means offsetting those costs with high bills for the privately-insured.
“It’s a pretty common thing,” said Brent Andrew, the hospital spokesperson. “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.”
But most medical billing experts say it is rare for major emergency rooms to be out-of-network with all private health plans.
“According to what I’ve seen, that’s unusual,” says Christopher Garmon, an economist at the University of Missouri Kansas City who studies surprise medical bills. “I’ve heard anecdotes of some hospitals trying a strategy like this but my impression is that it doesn’t last very long.”