The nation's hospitals in 1998 recorded their smallest spending increase on care for the poor in more than a decade, according to data from the American Hospital Association.
The AHA released the figures at the request of MODERN HEALTHCARE. They're derived from the association's annual survey of 5,015 acute-care hospitals.
Hospitals spent $19 billion, or 6% of their total expenses, on uncompensated care in 1998, the latest year for which figures were available.
That same year, hospitals posted an aggregate profit of $19.5 billion, or a margin of 5.7% (Dec. 6, 1999, p. 2).
The $19 billion in uncompensated-care costs represents a 2.7% increase in spending over 1997, the smallest annual dollar increase by hospitals since 1985. As a percentage of total expenses, the level of uncompensated-care spending remained constant at 6% in 1998 (See chart).
Uncompensated care is the total of charity care-which is given with no expectation of payment-and bad debt, or care given for which payment was expected but not received.
Carmela Coyle, the AHA's senior vice president for policy, said that though the level of uncompensated care spending has remained steady in recent years, the AHA will monitor whether the financial pressures hospitals experienced under the Balanced Budget Act of 1997 are reflected in coming years' data.
According to the latest U.S. Census Bureau data, there were 44.3 million uninsured Americans in 1998.
Providing uncompensated care does not solve the problem of the uninsured, said Cheryl Fish-Parcham, associate director of health policy for Families USA, a Washington-based healthcare consumer group.
"Uncompensated care isn't the best way to serve people, I think insurance is the best way to serve people," she said. "We really believe there needs to be an expansion of coverage."