Two regional providers, two different ways to approach patient debt

One county, two hospital systems, two very different ways of collecting debt.

That's the conclusion of USA Today, which examined patient debt lawsuits filed in Greene County, Missouri. It discovered that CoxHealth in Springfield and Mercy Health in Chesterfield--both not-for-profit providers--are worlds apart in aggressively pursuing patient debt. 

In 2013, CoxHealth sued its patients 17.5 times more often than Mercy did, as Mercy moved away from litigation against its patients. And when CoxHealth took legal actions, it garnished patient wages about one-third of the time, according to USA Today.

The aggressiveness brings to mind another non-profit Missouri acute care provider, Mosaic of Life Care. That institution used a for-profit subsidiary to sue about 6,000 of its former patients over the past five years, seizing about $12 million of their assets in the process. And in Oregon, legislation is pending that would slow down the collections process from providers of accident victims in order to ensure they are able to appropriately heal and collect judgments from the appropriate parties, Oregon Catalyst reported.

But even such aggressive legal actions can lead to unexpected outcomes. CoxHealth sued Renee Cook, whose terminally ill son Devon was treated by the system for mosaic chromosome disorder. For most of the period he was under the health system's care, Medicaid covered the entire bill. But years after he died in 2006, CoxHealth tried to collect more than $2,000 from Renee Cook, and then eventually sued her in 2011.

"It's terrifying," Cook told USA Today. "It was emotionally difficult to a certain degree, because you're trying to move forward, you've lost your son and you're learning to live your life, and then something comes up like this and dredges up those last few days."

The sum was apparently connected to one year when Cook earned slightly too much money to fully qualify for Medicaid. The sum owed ranged from about $2,000 to more than $2,700, depending on which hospital employee filed an affidavit. But another employee determined that Cox actually owed only $247. The lawsuit was dismissed when that sum was paid.

"They paid a boatload of money to come after me for $247, and I paid more than $247 because I had to get an attorney to help me," said Cox, who told USA Today that she spent about $600 on attorney's fees.

To learn more:
- read the USA Today article 
- check out the Oregon Catalyst article