It appears as if more bad debt is being reclassified as charity care in hospitals in Pennsylvania, driven in part by the use of software that analyzes patients on the notion of their presumptive eligibility for charity care programs.
Dozens of hospitals and healthcare systems throughout the state use such software to determine whether their patients are eligible for participation in their charity care programs, the Pittsburgh Post-Gazette reported. Those hospitals include the University of Pittsburgh Medical Center (UPMC), Allegheny Health Network, Wellspan Health and Geisinger Health System.
The newspaper noted that this use of sophisticated software likely explains a nearly doubling of the amount of money allocated to charity care over the past eight years.
In UPMC's case, the use of presumptive eligibility software changed the proportion of charity care (versus bad debt) from a little more than 35 percent in 2007 to 75 percent in 2014.
Many more hospitals and healthcare systems are expected to use presumptive eligibility software in the coming years, particularly as new regulations from the Internal Revenue Service come in force this year and will require hospitals to make more of an effort to determine the eligibility of patients for such programs and offer them assistance.
However, patient advocates are particularly rankled by the fact that many hospitals that use such software often don't notify patients if they qualify for charity care benefits. Among them are UPMC and Allegheny Health, according to the Post-Gazette. “There really shouldn’t be a secret financial assistance policy for some patients,” Julie Trocchio, senior director of community benefit at the Catholic Health Association, told the newspaper.
That appears to dovetail with a study conducted by the University of Michigan last year that concluded little more than 40 percent of hospitals notify patients about their eligibility for charity care prior to attempting to collect on their bill.
Some facilities, such as Allegheny General Hospital, automatically offer charity care once the software determines that a patient is eligible.
But hospital officials interviewed by the newspaper say there are often barriers to completing a charity care application, whether there is a language issue, patients do not believe they should qualify for free healthcare, or a belief that charity care would jeopardize their eligibility for another program, such as food stamps or public housing.