Not-for-profit hospitals in Georgia provided nearly five times as much charity care as for-profit hospitals did in 1993, according to a report by the Georgia State Health Planning Agency.
In 1993, 65 not-for-profit hospitals spent $184.6 million on charity care after deducting reimbursements from state and local governments for indigent care, the state report said. Fifty-four for-profit hospitals spent $38.8 million.
As a percentage of gross revenues, not-for-profits allocated 3.9% to charity care, compared with 2.7% by for-profits in 1993, the last year for which data were available.
Some 71 public hospitals provided $153.4 million in unreimbursed charity care, or 6.7% of gross revenues in 1993, the state report said. That figure is separate from the not-for-profits' charity-care data.
Representatives of for-profit hospitals in Georgia contended the data show there is little difference in provision of charity care between for-profits and not-for-profits.
Officials for Columbia Health System of Georgia, a division of Nashville, Tenn.-based Columbia/HCA Healthcare Corp. that operates 19 hospitals in the state, were unavailable for comment. However, James Slack, division president, told the local trade publication Georgia Health Care News, "This further demonstrates that charity care is not a not-for-profit vs. for-profit issue."
But a spokesman for the Georgia Alliance of Not-For-Profit Hospitals, an 80-member trade group, contended the state report paints a different picture.
"Not-for-profit hospitals spend a significantly higher amount on charity care than for-profit hospitals," said John Parker, an attorney with Parker, Hudson, Rainer & Dobbs, Atlanta. The law firm represents the GANFPH.
"The numbers are further skewed because for-profits charge more for their services than not-for-profit hospitals," Parker said.
Part of the reason for the large difference in charity-care spending is the larger average size of not-for-profit hospitals. The average size of a not-for-profit hospital in Georgia is 210 licensed beds, compared with 113 beds for for-profits.
On a per-licensed-bed basis, not-for-profit hospitals spent $13,524 on charity care, compared with $6,360 for for-profit hospitals in 1993, the state report said. A state spokeswoman said data for 1994 are being analyzed.
In Albany, 418-bed Phoebe Putney Memorial Hospital competes with 145-bed Palmyra Medical Centers. Phoebe Putney, a not-for-profit hospital, provided 5% of its gross revenues in charity care in 1993; Palmyra, a Columbia hospital, provided 1.5%, the state said.
In Macon, 518-bed Medical Center of Central Georgia, a not-for-profit hospital, provided 8.2% in charity care; 188-bed Coliseum Medical Centers, a Columbia hospital, provided just 0.2%.
The picture is a little more complicated in Augusta, where 613-bed University Hospital, a not-for-profit, provided 3.8% in charity care; 148-bed St. Joseph Hospital, a Roman Catholic facility, provided just 0.7% in charity care; and 488-bed Medical College of Georgia Hospital, a public hospital, provided 10.2% in charity care.
But Columbia's 252-bed Augusta (Ga.) Regional Hospital provided 6.7% in charity care, the state said. Augusta Regional operates a regional burn unit, which traditionally attracts high levels of charity care, said a state spokeswoman.
"The extraordinarily high charges of investor-owned hospitals like Augusta Regional skew the uncompensated-care statistics to suggest that such hospitals are providing more free care than they really are," said a 1994 report released by the GANFPH.
A spokeswoman for the Georgia Hospital Association said charity care alone is not an accurate reflection of community benefits provided by hospitals. Community benefits include bad debt, unreimbursed community services and charity care, said Holly Bates, a GHA spokeswoman.
"We don't know if community benefits are different (between not-for-profits and for-profit hospitals)," Bates said. "Hospitals provide about 10% of their revenue in uncompensated care. It does no good to argue who provides the most, the for-profit hospitals or the not-for-profit hospitals."
But earlier this year, the GANFPH used the charity-care argument to defeat a bill in the state Legislature that would have eliminated certificate-of-need planning.
The GANFPH argued that if for-profit hospitals were allowed to offer lucrative services such as open-heart surgery, not-for-profit hospitals would lose revenues and be less able to provide charity care.
Because the GHA supported maintaining CON, Columbia withdrew 18 of its 19 hospitals from the state association. The GHA lost $300,000 in dues, or 10% of its budget, Bates said.
"I truly believe Columbia will be back," said GHA President Joseph Parker. "Their leaving doesn't affect any of our programs or services."