Nonprofit hospitals' charity care disparities

Nonprofit hospitals that did the best financially provided less charity care relative to their income than their less-well-off peers, according to a new study in JAMA.

The big picture: Nonprofit hospitals are required to provide charity care in exchange for their tax-exempt status, but they're increasingly under fire for their aggressive bill collection practices against low-income patients.

By the numbers: In 2017, nonprofit hospitals collectively generated $47.9 billion in net income and provided $14.2 billion in charity care.

• The top-earning 25% of hospitals provided $11.50 in charity care for uninsured patients and $5.10 in charity care for the insured for every $100 of their overall net income, the study found.
• But the third quartile of hospitals provided $72.30 in charity care for the uninsured and $40.90 in charity care for the insured for every $100 of their net income.
• Hospitals in states that expanded Medicaid provided significantly less charity care than hospitals in other states.

What they're saying: "Nonprofit hospitals with substantial financial strength should consider more generous financial assistance eligibility criteria to reduce the financial risk exposure of disadvantaged uninsured and underinsured patients," the author concludes.

Go deeper:

• The corporatization of hospital systems
• When a hospital wields monopoly power