Ballad Health Sued Thousands of Patients in Poor, Rural Area

            This is a challenging blog to write. On one hand we say to people to pay their bills. On the other hand we have the plight of the poor. This article references 5,700 lawsuits against patients by Ballad Health in its first fiscal year as a health system, which ended in June and 5,400 in the prior year.

They say they are simply trying to collect revenue that is the responsibility of the patient. Ballad’s bad debt in fiscal 2019 was $141.2 million.

            One month ago I needed to go to an urgent care clinic for good ole traveler’s crud. Last week I received an unexpected bill for items not covered. While not promptly, I eventually wrote a check and paid the bill. This was even while having 2 sources of health insurance. Oh well, I was sick, got the care and paid my bill. But the article reports on individuals that don’t have this luxury. For example, a 38-year-old single mother who had to visit the emergency department for chest pain. She had an employer sponsored plan and received a bill for $1300. My bill was only $156. She subsequently lost her full time job, works part time and raises 3 kids as a single mother. She was sued. Right or wrong:

Ballad contacts a patient a minimum of seven times in the 120-day window between a late payment and sending them to collections, said Lynn Krutak, the system’s chief financial officer. After that, she said the collection agency works with those patients for another 90 days.

            Ballad wins more than 99% of the cases it takes to court, meaning a judge agreed Ballad took the proper collection steps, Krutak said. There are other health care facilities suing patients as well, such as UVA Health System in Charlottesville, Va, and Methodist Le Bonheur Healthcare in Memphis, Tenn. I’m not saying it’s wrong or it’s right but as more patients cover the cost of healthcare because of high-deductible plans or out-of-network billing, more hospitals will need to find ways to address uncompensated care. This because not-for-profit hospitals’ bad debt is projected to increase at least 8% this year as the high-deductible health plan trend continues. For example Atlanta-based Piedmont Health said it was trying to shave down its $250.7 million in bad debt by requiring patients who were responsible for their entire bill to pony up a quarter of the amount before receiving non-emergent services. Other health systems have outsourced thousands of revenue-cycle employees to third parties while others employ one-off technology solutions. Ballad increased its charity care so that patients whose household incomes fall below 225% of the federal poverty guidelines now get care for free. 

            The article says that they wouldn’t sue patients who are unemployed, making minimum wage, going through bankruptcy, 65 years old, or for very small or very large balances where there are likely extenuating circumstances. Another 39-year-old single mother had her case go to collections and affected her credit score down over 200 points. 

“On other hand, as a mission-driven organization that provides a lot of services to people who can’t afford to pay, as good stewards, we also have to try to collect from people who can pay,” he said. “And frankly, it’s an issue of fairness for the people who do pay their bill that we do what is appropriate to ensure that other people who can pay their bill pay their fair share.”

Make up your own mind. 



Join 3,553 other subscribers

Robert Duprey MD

Robert is a 2nd career physician (MD); a combat Veteran with the US Army; a former psychiatric nurse practitioner; an independent researcher; a medical writer; and now having passed USMLE Steps 1, 2CK, 2CS, and 3, is a residency applicant. 

  5 comments for “Ballad Health Sued Thousands of Patients in Poor, Rural Area

  1. DR SKM
    October 9, 2019 at 10:10 pm

    Hospitals enjoy a not-for-profit status, money from faith based organizations and have considerable political power in most medium sized towns as they are usually the single biggest employer. Even the most profitable hospital can appear in the red with some clever accounting and “losses.”

    They can cut costs and find ways to stay in the black if they wanted to.

  2. JRDO
    October 9, 2019 at 11:11 am

    The USA is a capitalist democracy system which is market based except for a few items deemed important enough for public funding, e.g. law enforcement & public infrastructure.
    Ballard is behaving as the capitalistic healthcare system has designed it to behave.
    Free market price control forces do not work in the presence of a for-profit third party payor system.
    Want make healthcare more affordable? Take the profits out via price controls. Hmm, sounds like socialism.
    Want to help the poor? Public funding is needed. Hmm, also sounds like socialism.

    Medical bills are the #1 cause for bankruptcy in the U.S.A.
    This doesn’t happen in any other western industrialized nation.

    Unless we follow the lead of these other countries and change our system, we will continue down the path of more and more Americans being impoverished by our current system. Small tweaks, e.g. price transparency regulations, will not change the outcome.

    As an aside, as a parent I am worried about my children growing up in a country where many American’s are one hospitalization away from bankruptcy and mass shooting are ever increasing (they aren’t even front page news anymore).

    • October 9, 2019 at 10:57 pm

      Health care insurance in the USA is NOT capitalistic or free-market by any stretch of the imagination. Allow open competition and enforce basic anti-monopoly laws within the “health care industry” and insurance providers and see how fast the prices drop.

      Or buy into the nonsense of MedicAid for all and see how fast the quality of health care drops.

      • JRDO
        October 10, 2019 at 8:58 am

        Definition of Capitalism: “an economic and political system in which a country’s trade and industry are controlled by private owners for profit, rather than by the state.”
        The presence of third party payors distort the usual free market price forces which makes for bad capitalism but capitalism nonetheless.
        Is the answer to outlaw third party payors?? I don’t think that would work well.

        I agree that quality will drop with Medicaid for all.
        Affordability, Quality, Universal Coverage- pick any two.
        No healthcare system can give all three but we seem to have a system that only delivers one.

  3. Celi E
    October 9, 2019 at 8:49 am

    They are greedy a$$holes. Hospitals get a Substantial tax break that physicians DONOT receive to provide charity care. No CEO should make more than the highest paid physician at their hospital . If they are not providing charity care tax them like a business. Maybe all the 6 million $ CEOs will find someone else to plague.

Comments are closed.