By Consumers for Quality Care, on December 14, 2022
An analysis from The Wall Street Journal has found that while federal requirements mandate that nonprofit hospitals establish financial-assistance policies for needy patients, they often put up unnecessary obstacles for consumers which make financial aid hard to attain.
Leukemia patient Ashley Harrison appeared to be a perfect candidate for financial assistance when she went to receive care at Advocate South Suburban Hospital near Chicago, part of a major nonprofit system. Harrison’s emergency room bill was over $36,000, and her annual income of $24,000 was well under the financial cutoff for full bill forgiveness. But neither of her two forms of insurance—Medicaid and a private plan—covered the cost. When she asked the hospital for financial help, the hospital first told her to wait to apply for aid while her insurance was pending, only then to tell her she had waited too long once she did apply.
“It was confusing, and long, and drawn-out,” Harrison said, adding that the bill was completely unaffordable. “There’s no way.”
The Wall Street Journal found that not all hospitals automatically prequalify low-income consumers for charity care, some hospitals send bills to qualifying patients before checking eligibility, and sometimes hospitals don’t provide notice to qualifying consumers that financial assistance is available, despite federal rules requiring nonprofit hospitals to disclose these policies to patients.
Not only do nonprofit hospitals spend little of their revenue on charity care, they often act like for-profit businesses, padding their bottom lines while seeking to get paid, even by those who can’t afford it.
CQC urges nonprofit hospitals to hold up their end of the bargain by providing charity care to those who need it and offering greater transparency of eligibility requirements for consumers.