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: February 23, 2026 at 3:13pm
Charity Care Spending
Ohio averaged a “fair share deficit” of nearly $ 1. 3 billio n from 2020 to 2022 , according to the Lown Institute. In other words, Ohio’s nonprofit hospitals pocketed a whopping $ 1. 3 billion 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 74 % of Ohio’s nonprofit hospitals ran 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 80 Ohio hospitals investigated by the Lown Institute from June 2024 to April 2025, 45% had written policies allowing them to take legal actions against patients for unpaid medical debt. Sixteen Ohio 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 Ohio:
Does not
Does not
Does not
Does not 3
Price Transparency
A survey of 2,000 hospitals nationwide from July t o November 2024 found that just 10 of the 80 Ohio hospitals reviewed – a mere 13 % 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 Ohio
Based on credit data from August 2025, Urban Institute found that 4% of Buckeyes have medical debt in collections , more than the national average of 3%. In Ohio’s communities of color, roughly 6% of people have medical debt in collections, exceeding the 4% national average.5
Medical Debt in Collections
Based on credit bureau data from August 2023, Urban Institute found that 6 % of Ohio’s hospitals have medical debt in collections , more than the national average of 5%. In Ohio’s communities of color, roughly 8 % of people have medical debt in collections, exceeding the 6% national average .6
Hospital Overcharging
On average, from 2020 to 2022, h ospitals in Ohio charged patients with private insurance an average of 276 % of what they charged Medicare patients for the same services .7
Hospital Safety
Ohio ranks 33rd in the country for hospital safety, with only 22.8 % of its hospitals earning an ‘A’ grade for safety.8
Hospital Price Variation
A 2025 review of Ohio hospital prices showed huge price variations for the same medical procedures. The price charged for a spinal fusion varied by as much as 24.6x from one hospital to the next.9
Additionally, some hospitals charged patients wildly different prices for the same procedure. Cleveland Clinic Main Campus, for example, charged some insurance plans as much as $20,862 for a C-Section and as little as $5,042 for the same procedure.10
Grade: #HospitalFail
Lown Institute, “Making Hospital Tax Breaks Work for Communities: An Analysis of 20 States,” https://lownhospitalsindex.org/report-making-hospital-tax-breaks-work-for-communities/
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
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,” November 2025, https://apps.urban.org/features/debt-interactive-map/?type=medical&variable=medcoll&state=39
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, Fall 2025, https://www.hospitalsafetygrade.org/your-hospitals-safety-grade/state-rankings
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
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
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.
