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 serve 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 care outcomes for patients.
Last updated: June 25, 2025 at 6:23am
Charity Care Spending
Minnesota averaged a “fair share deficit” of $ 487 million from 2020 to 2022 , according to the Lown Institute . In other words, Minnesota ’s nonprofit hospitals pocketed a whopping $ 487 million more in tax breaks tha n what they spent on community benefits and charity care for low-income patients . More than half of Minnesota’s nonprofit hospitals -55% – average d a fair share deficit for the period. 1 And for the 2021 fiscal year , the nonprofit Mayo Clinic’s Rochester hospital had the seventh highest fair share deficit of all nonprofit hospitals in the country. 2
Charity Care Practices
According to an investigation by the Post Bulletin, some patients of the Mayo Clinic in Rochester were not informed that they were eligible for charity care, were charged full price despite being eligible for charity care and were even sued as a result of being unable to pay to the full bill.
Twelve of the 14 charity-care eligible patients interviewed by the Post Bulletin said that “Mayo made no mention of charity care when they called for help with an unaffordable bill. Additionally, the two patients who discussed discounted care with Mayo said that they were informed about it “only when they explicitly asked.”3
Hospital Collection Policies
O f the 14 Minnesota hospitals investigated by KHN from November 2021 to December 2022 , 71 % ha d written policies allowing them to sue their patients or take other legal actions to collect unpaid medical bills. Six hospitals’ policies even allowed them to deny nonemergency care to patients who owe the hospital money .4
Medical Debt and Consumer Protections
Minnesota’s consumer protection policies for medical debt are rated as “WEAK.” For example, Minnesota:
Does not prohibit medical providers from seizing patients’ bank accounts to collect a medical debt. Does not prohibit hospitals from selling a patient’s medical debt. Does not require hospitals to offer a reasonable payment before sending a patient’s bill to collections. Does not require hospitals to screen patients for insurance eligibility and eligibility for other programs or discounts. 5 Price Transparency
A survey of 2,000 hospitals nationwide from July to November 2024 found that only 1 of the 32 Minnesota hospitals reviewed – a mere 3 % – had complied with federal regulations requiring all hospitals to post their prices online and make them easily accessible and searchabl e .6
The Burden of Medical Debt in Minnesota
In Minnesota , an average of 7 . 6 % of adults in a given year ( or 330 ,000 people) report ed having medical debt , according to a Peterson-KFF analysis of data from 2019 to 2021.7
Hospital Overcharging
On average, from 2020 to 2022, h ospitals in Minnesota charged patients with private insurance an average of 237 % of what they charged Medicare patients for the same services .8
Hospital Safety
Minnesota ranks 4 5 nd in the country as regards hospital safety, three spots lower than last year, with just 9 % of its hospitals earning an ‘A’ grade for safety.9
Grade: #HospitalFail
Lown Institute, “Making Hospital Tax Breaks Work for Communities: An Analysis of 20 states,” April 2025, https://lownhospitalsindex.org/report-making-hospital-tax-breaks-work-for-communities/
Lown Institute, “Lown Institute Hospitals Index: 2024 Results Fair Share Spending,” April 2024, https://lownhospitalsindex.org/hospital-fair-share-spending-2024/
The Rochester Post Bulletin, “They could have qualified for charity care. But Mayo Clinic sued them,” November 2022, https://www.postbulletin.com/newsmd/they-could-have-qualified-for-charity-care-but-mayo-clinic-sued-them
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/MN
PatientRightsAdvocate.org, “Sixth Semi-Annual Hospital Price Transparency Compliance Report,” February 2024, https://www.patientrightsadvocate.org/semi-annual-report-feb2024, pg. 24
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/
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, May 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.
