1 Lown Institute, “Lown Institute Hospitals Index: 2023 Results Fair Share Spending,” April 2023,

2  Lown Institute, “Lown Institute Hospitals Index: 2022 Results Fair Share Spending,” 25 Systems With Largest Fair Share Deficits, April 2022,

3 National Public Radio, “Investigation: Many U.S. hospitals sue patients for debts or threaten their credit,” December 2022,

4 Innovation for Justice, University of Arizona and the University of Utah, “Medical Debt Policy Scorecard,” October 2021,

5, “Fourth Semi-Annual Hospital Price Transparency Compliance Report,” July 2023,, p. 26

6 Rand Corporation, “Nationwide Evaluation of Health Care Prices Paid by Private Health Plan: Findings from three Round 3 of an Employer-Led Transparency Initiative,” October 2021,

7 Axios, “How America’s Top Hospitals Send Patient Costs Soaring,” June 2021,

8 Los Angeles Times, “Hospitals had to put charity care rules on their websites months ago. Some didn’t do it,” November 29, 2022,

All data as of February 2024.