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: January 9, 2026 at 9:21pm
Charity Care Spending
Indiana nonprofit hospitals averaged a “fair share deficit” of $7 16 million dollars from 2020 to 2022 , according to the Lown Institute Hospitals Index. In other words, Indiana’s nonprofit hospitals pocketed a whopping $716 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 70 % of Indiana’s nonprofit hospitals averaged a fair share deficit for that period .1
Hospital Collection Policies
Most hospitals (59%) allow at least one extraordinary collection action, like wage garnishments, selling debt to a third party or denying non-emergency care. Of the 58 Indiana hospitals investigated by the Lown Institute from June 2024 to April 2025, 64% had written policies allowing them to take legal actions against patients for unpaid medical debt. Fourteen Indiana hospitals’ policies even allowed them to deny nonemergency care to patients who owe the hospital money.2
Medical Debt and Consumer Protections
Medical debt adversely affects many Americans. Given vague and rarely enforced federal medical debt protections, states are on the frontlines of patient medical debt protections. Unfortunately Indiana:
Does not
Does not
Does not 3 Price Transparency
A survey of 2,000 hospitals nationwide from July 2024 to November 2024 found that just 5 of the 45 Indiana hospitals reviewed – a mere 11 % percent – had complied with federal regulations requiring all hospitals to post their prices online and make them easily accessible and searchable.4
Hospital Price Variation
A 2025 review of Indiana hospital prices showed huge price variations for the same medical procedures. The price charged for a Caesarean Section varied by as much as 18x from one Indiana hospital to the next.5
Additionally, some hospitals charged patients wildly different prices for the same procedure. IU Health Methodist Hospital in Indianapolis, for example, charged some insurance plans as much as $91,000 for a hip or knee replacement and as little as $3,500 for the same procedure.6
The Burden of Medical Debt in Indiana
In Indiana , an average of 12 % of adults in a given year (or 600,000 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 %.7
Medical Debt in Collections
Based on credit bureau data from August 2025, Urban Institute found that 5 % of Indianans have medical debt in collections , more than the national average of 3%. In Indiana ’s communities of color, roughly 5 % of people have medical debt in collections, exceeding the 4% national average .8
Hospital Overcharging
Hospitals in Indiana charged patients with private insurance an average of 2 33 % of what they charged Medicare patients for the same services .9
Hospital Safety
Indiana ranks 36th in the country for hospital safety, with only 21 % of its hospitals earning an ‘A’ grade for safety.10
Grade: #HospitalFail
Lown Institute, “Making the hospital tax exemption work for communities, An analysis of nonprofit hospitals in twenty states,” April 2025, https://lownhospitalsindex.org/wp-content/uploads/2025/04/fair-share-2025-national-report-20250409.pdf , pg. 15
Lown Institute, “Hospital Financial Assistance and Debt Collection Policies,” June 2025, https://lownhospitalsindex.org/report-hospital-financial-assistance-and-debt-collection-policies/
Commonwealth Fund, “State Protections Against Medical Debt: A Look at Policies Across the U.S. in 2025,” July 2025, https://www.commonwealthfund.org/publications/fund-reports/2025/jul/state-protections-against-medical-debt-look-policies-across-us
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
PatientRightsAdvocate.org, “The Interim Semi-Annual Hospital Price Transparency Report,” September 2025, https://www.patientrightsadvocate.org/interim-semi-annual-hospital-price-transparency-report , Appendix D, pg. 62
PatientRightsAdvocate.org, “The Interim Semi-Annual Hospital Price Transparency Report,” September 2025, https://www.patientrightsadvocate.org/interim-semi-annual-hospital-price-transparency-report , Appendix B, pg. 31
Peterson-KFF Health System Tracker, “Access & Affordability: The Burden of Medical Debt in 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=18
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.
