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.