While nonprofit hospitals are organized as charities to deliver affordable health care to those in their communities who need it most, many of America’s nonprofits are making big money. Nonprofit hospitals around the country are paying executives exorbitant salaries and adopting policies that put profits over patients, like pursuing predatory collection practices, closing hospitals that are critical to underserved areas but aren’t performing financially, and failing to provide free or reduced-cost care for qualifying low-income patients. Too often, these policies are combined with poor health outcomes for patients.
Last updated: June 25, 2025 at 6:13am
Charity Care Spending
Arkansas had a “fair share deficit” of nearly $194 million for the fiscal year ending in 2021, according to the Lown Institute Hospitals Index. In other words, Arkansas nonprofit hospitals pocketed a whopping $194 million more in tax breaks than they spent on community benefits and charity care for low-income patients. In fact, the Lown Institute found that nearly 90% of Arkansas’s nonprofit hospitals ran a fair share deficit in the 2021 fiscal year.1
Hospital Collection Policies
Of the 10 Arkansas hospitals investigated by KHN from November 2021 to December 2022, 50% had written policies allowing them to report unpaid medical bills to credit-rating agencies. 80% had policies allowing them to sue patients or take other legal actions to collect unpaid medical bills.2
Medical Debt and Consumer Protections
Arkansas consumer protection policies for medical debt are rated as “poor.” For example, Arkansas:
Does not mandate screening of patients for insurance eligibility and eligibility for other programs, including entities’ charity or discounting policy.
Does not require hospitals and other healthcare providers to offer a reasonable payment plan before sending bill to collections.
Does not require hospitals and other healthcare providers to establish and notify patients of charity care policies prior to collecting payment and in every collection communication
Does not prohibit or limit sending a bill to collections or credit reporting while the patient is appealing to insurance, applying for financial assistance, negotiating bill, or in a payment plan, or while the patient is applying for coverage of necessary care.3
Price Transparency
A survey of 2,000 hospitals nationwide from July to November 2024 found that just three of the 25 Arkansas hospitals reviewed – a mere 12% percent – had complied with federal regulations requiring all hospitals to post their prices online and make them easily accessible and searchable.4
The Burden of Medical Debt in Arkansas
In Arkansas, an average of 10.7% of adults in a given year (or 240,000 people) reported having medical debt, according to a Peterson-KFF analysis of data from 2019 to 2021. That’s more than the national average of 8.6%.5
Medical Debt in Collections
Based on credit bureau data from August 2023, Urban Institute found that 7% of Arkansas have medical debt in collections , more than the national average of 5%. In Arkansas communities of color, roughly 10% of people have medical debt in collections, exceeding the 6% national average.6
Hospital Overcharging
On average, from 2020 to 2022, hospitals in Arkansas charged patients with private insurance an average of 162% of what they charged Medicare patients for the same services.7
Hospital Safety
Arkansas ranks 39th in the country for hospital safety, with just 20% of its hospitals earning an ‘A’ grade for safety.8
Grade: #HospitalFail
Lown Institute, “Lown Institute Hospitals Index: 2024 Results Fair Share Spending,” April 2024, https://lownhospitalsindex.org/hospital-fair-share-spending-2024/
National Public Radio, “Investigation: Many U.S. hospitals sue patients for debts or threaten their credit,” December 2022, https://www.npr.org/sections/health-shots/2022/12/21/1144491711/investigation-many-u-s-hospitals-sue-patients-for-debts-or-threaten-their-credit
Innovation for Justice, University of Arizona and the University of Utah, “Medical Debt Policy Scorecard,” October 2021, https://www.medicaldebtpolicyscorecard.org/state/AR
PatientRightsAdvocate.org, “Seventh Semi-Annual Hospital Price Transparency Compliance Report,” November 2024, https://www.patientrightsadvocate.org/seventh-semi-annual-hospital-price-transparency-report-november-2024 , pg. 28
Peterson-KFF Health System Tracker, “Access & Affordability: The Burden of Medical Debt in the United States,” February 2024, https://www.healthsystemtracker.org/brief/the-burden-of-medical-debt-in-the-united-states/
Urban Institute, “Debt in America: An Interactive Map,” September 2024, https://apps.urban.org/features/debt-interactive-map/?type=medical&variable=medcoll&state=5
Rand Corporation, “Prices Paid to Hospitals by Private Health Plans: Findings from Round 5.1 of an Employer-Led Transparency Initiative,” December 2024, https://www.rand.org/pubs/research_reports/RRA1144-2-v2.html
Leapfrog Hospital Safety Grade, State Rankings, Spring 2025, https://www.hospitalsafetygrade.org/your-hospitals-safety-grade/state-rankings
Consumers for Quality Care (CQC) is a coalition of advocates and former policymakers working to provide a voice for patients in the health care debate as they demand better care. CQC is led by a board of directors that includes the Honorable Donna Christensen, physician and former Member of Congress; Jim Manley, former senior advisor to Senators Edward Kennedy and Harry Reid; Jason Resendez, community advocate and health care strategist; and Mary L. Smith, former CEO of the Indian Health Service.
