Study finds altered billing and collection practices

Healthcare Financial Management, Dec, 2005

The Center for Studying Health System Change has found many hospitals have adopted more generous charity care guidelines for uninsured patients in the aftermath of publicity about aggressive hospital billing and collection practices and several dozen lawsuits alleging hospitals overcharged uninsured patients. The findings are reported in a new HSC issue brief, Balancing Margin and Mission: Hospitals Alter Billing and Collection Practices for Uninsured Patients. The study is the result of site visits to 12 nationally representative communities: Boston; Cleveland; Greenville, S.C.; Indianapolis; Lansing, Mich.; Little Rock, Ark.; Miami; northern New Jersey; Orange County, Calif.; Phoenix; Seattle; and Syracuse, N.Y.

Other key findings of the study include:

* It is now common for hospitals to provide charity care to uninsured people with incomes under 200 percent of the federal poverty level, or $38,700 for a family of four in 2005, and offer sliding-scale discounts beyond this income threshold, in some cases up to 400 percent or 500 percent of the poverty level.

* Some hospitals have restricted access to care for some uninsured--for example, some public hospitals limit nonemergency care for uninsured out-of-county residents.

* Most changes in billing and collection policies have had negligible impact on hospital finances to date.

To read Balancing Margin and Mission: Hospitals Alter Billing and Collection Practices for Uninsured Patients, go to www.hschange.org/ CONTENT/788.