Hospital self-pay policies vary widely

Not-for-profit and tax-exempt hospitals' protocols for self-pay patients--whether to write their bills off entirely as charity care or insist on years of payments--vary widely from facility to facility, according to 100Reporters.

St. Anthony Hospital in Denver, part of the Catholic Health Initiatives network, collects $50 upfront from self-pay patients, according to the article. By contrast, Jackson Memorial Hospital in Elgin, N.D., requires that self-pay patients pay the facility 10 percent of their total bill, regardless of whether it takes years or decades to do so. Spectrum Health in Grand Rapids, Mich. cares for any patient with an income below the federal poverty level free of charge.

Intermountain Health Care, Utah's predominant hospital network, uses tough collection tactics to collect out-of-pocket shares, including sending collection agents to patients' bedsides, according to 100Reporters.

Such tactics mirror what occurred at a group of hospitals operated by Fairview Health Services in Minnesota, which allowed Chicago-based Accretive Health to engage in hardball collection tactics. Under pressure from the Minnesota Attorney General, Accretive agreed to exit the state for several years.

"Keep in mind that not all tax-funded services are considered charity: think of public schools, police and fire departments. It is only when low-income people are separated from others that services are considered charity," Merle Lenihan, M.D., a Texas physician who studied the charity care issue for a recent doctoral degree, told 100Reporters. "Underneath the blanket of moral goodness that comes from 'charity care,' there is a lot of needless suffering."

Meanwhile, public facilities such as San Francisco's Laguna Honda Hospital exhausted a $2 million patient fund on catered events for hospital employees, among other non-patient perks, according to 100Reporters. Hospital officials claim the allegations were unsubstantiated.

To learn more:
- read the 100Reporters article

Related Articles:
Is Accretive Health in a death spiral?
Hospital collection firm fined, banned from state
5 much better ways to collect patient debt
Hospital collection firm sued for harsh practices
Are hospitals fudging charity care numbers?
IRS proposes new rules to govern charity care