Though hospitals have an obligation to offer free care, they often fail to alert potential recipients and sometimes use harsh collection tactics when the bills are not paid, according to a study by Community Catalyst, a Boston-based health care advocacy organization.
Both for-profit and not-for-profit hospitals are expected--and in some cases, required--to provide free care and other community benefits, Community Catalyst says in the report, released Wednesday.
But the group says it found that most hospitals fail to inform low- and moderate-income patients without insurance that free care is available and then often send the bills to collection agencies.
The study involved interviews in nine markets: Long Island, N.Y., Columbus, Ohio, Washington, D.C., Chicago, Ill., Salem, Ore., Portland, Ore., Champaign, Ill., Alexandria, Va., and Hartford, Conn.
In one example, at a hospital in Illinois, an uninsured woman with a history of severe pneumonia wound up with a bill of close to $22,000 three years ago when she was suddenly hospitalized, Community Catalyst reports.
The group says that no one at the hospital told her she might qualify for free care. Instead, the hospital sent bill collectors after her, then sued her for $22,000. Today she and her husband are behind in their mortgage and may have to file for bankruptcy.
Community Catalyst recommends that:
- Hospitals provide free care to the uninsured with incomes up to 200% of the federal poverty level ($30,520 for a family of three), and partial free care for those with incomes up to 400%.
- Hospitals be required to make standardized reports on how much free care they provide.
- Patients who cannot pay their bills be protected from collection actions such as foreclosures, property liens and wage garnishments.