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Advocates Demand Clarity About Options For Patients In Financial Need

By Jessica Marcy

January 20th, 2012, 5:19 PM

Many Americans continue to struggle with the high cost of medical care, unaware that non-profit hospitals are required to provide information about potential financial assistance or relief. But, a provision in the 2010 health law seeks to clarify what help hospitals should offer.

Advocates were on Capitol Hill Friday to raise awareness about the provision and to call on hospitals and community groups to increase access to care while also controlling costs. The health law requires hospitals to fulfill four requirements:  to develop written financial assistance policies that they make available to patients, to limit what they charge for services, to observe fair billing and debt collection practices, and to conduct regular community needs assessments to make sure help is going to communities that need it most.

Michael Miller, policy director at the national health advocacy group Community Catalyst, said that the need exists in the community for care for the uninsured. He said that hospitals and community groups must now figure out “what’s the most rational way to do this instead of [asking] are we going to pay for this or not.”

For years, non-profit hospitals have received federal tax-exemption if they provide financial help, often called charity care or indigent care, to needy patients.  However, those hospitals, which represent 60 percent of hospitals nationally, often have inconsistent policies, and many have failed to get the word out to patients about what they offer. That failure has led some patients to fall into medical debt, which has become the leading cause of bankruptcy in the U.S. and has led to nearly half of foreclosures, according to Community Catalyst.

“Small amounts of medical debt can send families into a financial tailspin,” said Cathy Levine, executive director of the Universal Health Care Action Network of Ohio. “Protecting people from the crippling effects of medical debt has become especially important in this economy.”

Many hospitals fear that they would become flooded with needy patients who couldn’t pay their bills if they publicized charitable care, Levine said. But, she stressed, patients should be told about a hospital’s program immediately if they don’t have insurance coverage — typically the first question a hospital asks upon admittance. “It should be part of getting health care,” Levine said.

Matt Fishman, vice president for Community Health at Partners Healthcare in Boston, recalled that Brigham and Women’s Hospital didn’t have a sufficient financial assistance program in the early 1990s and worked with the advocacy group Health Care for All to figure out how to strengthen its policy.

8 Responses to “Advocates Demand Clarity About Options For Patients In Financial Need”

  1. JonathanN says:

    That is super information! Thanks for sharing! I’m going to Tweet about your blog.

  2. Ted Herman says:

    Here’s a solution. First dollar coverage for all care, to all in need, provided by an expanded and improved Medicare for all, single payer system, financed through progressive taxation and administered (for hospitals) via global budgets based on regional need assessment. Reform delivery system with emphasis on primary care, build integrated systems that salary all providers of care. Result: no more self-inflicted, time and resource wasting exercises like the one described in this article.

  3. Rich says:

    Here’s my suggestion. Regarding the Affordable Care Act, if opponents of the individual mandate win and, in June 2012, the Supreme Court rules that the individual mandate is unconstitutional, then all mandates should be declared unconstitutional and hospitals should close their emergency rooms to the uninsured and no longer be required to take charity cases. Opponents need to see the error of their ways. Opponents need to see that the individual mandate will help “everyone” and they need to see that, with the individual mandate, hospitals would no longer need to provide charity care to the uninsured since everyone would have insurance coverage. It’s a no-brainer! Except for the complete morons that oppose the individual mandate. Talk about stupid? Individual mandate opponents are really dumb!

  4. Nicole J. says:

    Everyone will not be covered under health insurance by the Affordable Care Act. There will still be over 23 million uninsured people in America – undocumented immigrants, those who make too little to afford health insurance (even with federal subsidies), to name two groups.

    So this information about financial assistance is severely needed. It may not need to be advertised, but it should be made available to all patients presenting without insurance.

  5. Rich says:

    Nicole J.; Where did you get these “facts”? If the individual mandate is ruled constitutional and the Affordable Care Act (ACA) continues to roll out and remains unchanged, every single American must have insurance coverage beginning in 2014. Didn’t you read the new law? The ACA provides subsidies for low income people. Those who can’t afford health insurance will get help. Are you just making up stuff about the ACA to scare people like Republicans always do? So far, this new law is working. It’s working very well. Seniors and students really like the new benefits they are getting now. It still has more great benefits coming in 2012, 2013 and 2014. I guess the next thing you will be telling us is about “death panels”, right? Admit it, it’s not really about the new law because most of the ideas in the ACA are traditional Republican ideas. The real thing you don’t like is that Obama got it passed and enacted, right? Be honest Nicole, it about partisan politics, right? It’s about the November 2012 election, right?

  6. Spring Texan says:

    Rich, Nicole is very well-informed indeed — and you are not.

  7. Lynn in SC says:

    As long as the crazy quilt of providers remains unconnected and the entrance to care remains the hospital ED, then hospitals will carry the burden of providing care to all. Better connecting points of care by linking the uninsured to the financing resources needs to be focused on directing and supporting patients to find the best level of care for the patient’s needs. This can’t happen after the fact of care in a hospital but at the front end of care. Assistance in navigating through the maze is as needed as assistance in financing care.

  8. Rich says:

    Oh, I forgot! Thanks for reminding me Texan. Nicole get’s her “facts” from the Tea Bag manifesto, right? The same bible you use?

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