A recent survey by Kaiser Health News found that many US hospitals have aggressive policies for patients who can’t pay their bills. Policies include lawsuits, reporting to credit rating agencies, selling the debt to collectors, and even denying non-emergency care. Medical debt affects one in five US households and the average debt is $21,687. The burden falls hardest on middle income, Black and brown households and people with disabilities. Medical debt is forcing families to cut back on food and other essentials, empty retirement funds, load up credit cards, and borrow from family.
Kaiser Health News surveyed 528 hospitals across the nation, including three in Connecticut – Stamford, UConn Dempsey, and Windham hospitals. In good news, all three provide free care to people with incomes below 250% of the federal poverty level ($33,975 for an individual, $57,575 for a family of three).
Unfortunately, UConn/Dempsey’s policies allow denial of non-emergency care to patients with outstanding debt. Windham Hospital only offers discounted care for slightly higher income patients if they are uninsured. Many debtors have insurance but with very high deductibles. Stamford offers no aid to patients with very high bills. All three hospitals allow reporting to credit rating agencies, the sale of patient debt (Stamford exempts some cases but they don’t specify which), and all allow lawsuits, liens, or wage garnishments (UConn and Windham state that the last is not current practice).
|Financial Assistance Policies|
|Who qualifies for free care? (income % federal poverty level)||250%||250%||250%|
|Who qualifies for discounted care?||250-400%||250-400% — only uninsured patients||250-400%|
|Provides aid to patients with very large medical bills?||No||Bills over 25% of monthly income||Bills over 50% of monthly income|
|Financial Assistance Policy available online?||Yes||Yes||Yes|
|Billing and Collections Policies|
|Allows reporting of patients to credit rating agencies?||Yes||Yes||Yes|
|Allows sale of patient debt?||Yes, in some cases||Yes||No|
|Allows denial of non-emergency care for patients with debt?||No||Yes||No|
|Allows lawsuits against patients, liens, or wage garnishment?||Yes||Yes, but not current practice||Yes, but not current practice|
|Collection policies available online?||Yes||Yes||Some, not all|
|Hospital financial structure|
|Independent or system?||Independent||Independent||Part of Hartford Healthcare|
|Total profit margin 2021||11.2%||-27.0%||6.3%|
|Uncompensated care % of total expenses 2021||3.2%||1.5%||1.9%|
Sources: Hundreds of Hospitals Sue Patients or Threaten Their Credit, a KHN Investigation Finds. Does Yours? 12/21/2022, Kaiser Health News; Financial Status of Connecticut’s Short Term Acute Care Hospitals for Fiscal Year 2021, September 2022, CT Office of Health Strategy.
All three hospitals incurred some uncompensated care last year; Stamford was highest at 3.2% of total expenses. Stamford and Windham also made healthy profit margins last year of 11.2% and 6.3%, respectively, while UConn Dempsey lost 27.0%. Stamford and UConn Dempsey are independent hospitals, but Windham is part of Hartford Healthcare.