Dive Brief:
- With the exchanges up and running and Medicaid expansion occurring in nearly half of all states, hospitals are beginning to look at their charity care policies. Because insurance is more widely available, some hospitals are scaling back their own charity care.
- BJC HealthCare, with hospitals in Illinois and Missouri, is requiring patients to pay at least something toward their care. They have also reduced their discounted care for patients—lowering it from four times the federal poverty level to three times that amount. At Southern New Hampshire Medical Center in Nashua, patients who were eligible to purchase health insurance or receive Medicaid but did not will not receive charity care.
- The Affordable Care Act mandates that hospitals help determine if patients qualify for payment assistance or insurance before beginning collections. Hospitals are now struggling with whether or not people are choosing not to get care, weren't aware of options or simply couldn't afford insurance—and what the balance of responsibility is between keeping revenue up and still providing care to as many as possible.
Dive Insight:
If hospitals provide free care to patients, will it keep individuals from paying for health insurance? This is a question hospitals will have to wrestle with in the coming years. Providers will have to continue offering financial assistance programs, but with more people acquiring insurance, it is likely that larger numbers of providers will begin altering those policies.
Nonprofit hospitals in the past have received media scrutiny for not offering enough charity care to patients. In 2011, the Advisory Board Company found that many hospitals already offer less than 2% of their total expenses in subsidized care. Now they will have to walk the line between discouraging individuals from getting insurance and offering assistance to patients who need assistance.
Want to read more? You may enjoy this story about a controversial California law that would set charity care minimums; or this story on charity care, bad debt and the myth of "affordable health care."