Advocates Demand Clarity About Options For Patients In Financial Need

Many Americans continue to struggle with the high cost of medical care, unaware that non-profit hospitals are required to provide information about potential financial assistance or relief. But, a provision in the 2010 health law seeks to clarify what help hospitals should offer.

Advocates were on Capitol Hill Friday to raise awareness about the provision and to call on hospitals and community groups to increase access to care while also controlling costs. The health law requires hospitals to fulfill four requirements:  to develop written financial assistance policies that they make available to patients, to limit what they charge for services, to observe fair billing and debt collection practices, and to conduct regular community needs assessments to make sure help is going to communities that need it most.

Michael Miller, policy director at the national health advocacy group Community Catalyst, said that the need exists in the community for care for the uninsured. He said that hospitals and community groups must now figure out “what’s the most rational way to do this instead of [asking] are we going to pay for this or not.”

For years, non-profit hospitals have received federal tax-exemption if they provide financial help, often called charity care or indigent care, to needy patients.  However, those hospitals, which represent 60 percent of hospitals nationally, often have inconsistent policies, and many have failed to get the word out to patients about what they offer. That failure has led some patients to fall into medical debt, which has become the leading cause of bankruptcy in the U.S. and has led to nearly half of foreclosures, according to Community Catalyst.

“Small amounts of medical debt can send families into a financial tailspin,” said Cathy Levine, executive director of the Universal Health Care Action Network of Ohio. “Protecting people from the crippling effects of medical debt has become especially important in this economy.”

Many hospitals fear that they would become flooded with needy patients who couldn’t pay their bills if they publicized charitable care, Levine said. But, she stressed, patients should be told about a hospital’s program immediately if they don’t have insurance coverage — typically the first question a hospital asks upon admittance. “It should be part of getting health care,” Levine said.

Matt Fishman, vice president for Community Health at Partners Healthcare in Boston, recalled that Brigham and Women’s Hospital didn’t have a sufficient financial assistance program in the early 1990s and worked with the advocacy group Health Care for All to figure out how to strengthen its policy.