As the financial crisis worsens, Vanderbilt Medical Center anticipates an increase in "charity care" as citizens' access to healthcare decreases.

According to Vice President of Finance for Clinical Enterprise Warren Beck, the increased number of layoffs has barred people's access to health insurance, which in the past would have been provided by employers. VUMC revenues are mainly generated by patient care, which is covered by insurance and over 65 percent of payment comes from Medicaid.

"We (the medical center) are still a needed commodity, it's just a question of whether or not we get paid," said Beck.

The Vanderbilt ER is required to provide services for a patient who has a "real emergency" until the patient is considered healthy or until death. However, in the past few years, the percent of charity cases have increased significantly.

"In the 2005 fiscal year, our percentage of revenues for uncompensated care was 4.6 percent; in 2008 our percentage of uncompensated revenues is 7.3 percent," Beck said.

Hospitals across the nation are also being affected by the debt crisis in terms of expansion and building.

"The is a freeze on credit, and many hospitals are engaging in building projects. They need to have access to debt markets; if there is not debt to be had, it's pretty hard to get in and complete their projects," Beck said.

Beck said VUMC is in good financial condition because the hospital has a very high credit rating, and the board is making sure the Med Center is not "over extended."