North Carolina hospitals, which are led by North Carolina’s largest public health system, have sued thousands of patients since 2017, but US hospitals routinely seek to collect bills from people who delinquent. A new analysis has emerged that sheds more light on the offensive tactics in use.
The report, produced by state treasurers and researchers from the Duke University School of Law, and interviews with associated patients, reveals the misery of people chased for tens of thousands of dollars and often spooked by the liens hospitals have placed on their parents’ homes. provides an explanation.
In some cases, spouses were targeted after the partner died. Also, patients interviewed by the researchers said they were surprised to learn about real estate liens only after they tried to sell their homes or after the parents who owned them passed away.
“I know my house will never be mine. and won a $192,000 judgment against her 79-year-old husband, whose debt accounted for more than half of the couple’s balance.
Ms Lindaberry said the hospital initially told her she could get help with her medical bills, but then declined to apply for the subsidy. “People don’t really care if God is money,” she told researchers.
The North Carolina findings support investigations by KFF Health News and NPR that most U.S. hospitals have resorted to tactics such as litigation, selling patient accounts to bond buyers and reporting patients to credit rating agencies. was found to maintain a policy of actively prosecuting patients for non-payment. .
About 100 million people nationwide (41% of adults) have some form of medical debt, according to a KFF poll. Health care debt is highest in the South, where chronic disease is more prevalent, and many states have not expanded the Medicaid safety net through the Affordable Care Act. (North Carolina expanded Medicaid only this year.)
The North Carolina State Treasurer released the new report as more and more states, including North Carolina, work to expand patient protections in the face of lobbying by the hospital industry.
“This is just one example of how hospitals put profits ahead of patients. It’s like an onion. The more you peel it off, the more you cry,” he said of hospital pricing and debt collection practices for years. Republican Treasury Secretary Dale Folwell, who has objected, said. “We should stop breaking people’s kneecaps to collect these debts.”
Atrium and other large tax-exempt health care programs say many health care systems do not provide adequate financial support to low-income patients, leaving large bills on those who should be entitled to help. It is under scrutiny as evidence mounts.
The new report, based on a five-and-a-half-year analysis of court records from 2017 to 2022, identifies 5,922 debt collection cases covering more than 7,500 patients and their families.
The lawsuits resulted in more than $57 million in judgments for hospitals, including millions of dollars in interest and other costs owed to patients and their families, the researchers said. was
North Carolina law allows hospitals to charge 8% interest annually on unpaid debt, which has increased some families’ debts by tens of thousands of dollars over the years, researchers say. found. Overall, interest accounted for nearly one-third of total judgments recorded in debt litigation.
The report also noted that lawsuits are undermining the economic security of generations of North Carolinians. A hospital can pursue a patient’s medical debts against the family, and a lien on the property will erode the value of the home even after the patient dies. “Thus, these lawsuits may target the family’s primary source of capital for surviving spouses and children,” the authors write. “Healthcare debt could accelerate the cycle of intergenerational poverty.”
Researchers found Atrium to be the most aggressive in collecting debts. Atrium, a healthcare system with roots as a public hospital in Charlotte, is now a multistate behemoth with $27 billion in annual revenue after merging with Midwest-based Advocate Aurora last year. Atrium filed approximately 2,500 lawsuits against patients between January 1, 2017 and June 30, 2022.
Atrium is also pushing loans from private equity-backed lender AccessOne to patients who can’t afford their medical bills, at interest rates that can reach as high as 13%, KFF Health News reports. This was revealed in last year’s survey.
Atrium declined to answer questions about the litigation on file or to have CEO Eugene Woods present on its debt collection practices.
The second most litigated regime is much smaller. He runs only one inpatient hospital in Carromont Health, Gastonia, North Carolina, a small city about 20 miles west of Charlotte. However, it filed about 1,800 lawsuits against patients between 2017 and mid-2022, according to the report.
Caromont declined to meet with Chief Executive Chris Peek, but a spokesperson said the system is unlikely to sue. “We take seriously our obligation to partner with our patients in all aspects of our care and services, and we always strive to resolve these issues with compassion,” Meghan Barney said in a statement.
In contrast to Atrium and Carromont hospitals, some North Carolina hospitals filed only one or two lawsuits against patients between 2017 and 2022, said a Duke University law professor. A study by a research team led by Barack Richman found that.
Similar analyzes of court records from Wisconsin, New York, Maryland, and other states in recent years reveal extensive use of the court system by hospitals. And KFF Health News revealed last year that more than two-thirds of U.S. hospitals have sued their patients or taken other legal action against them, including wage garnishment and property liens. did. This analysis is based on a sample survey of over 500 hospitals nationwide.
This focus on debt collection activities has helped fuel national efforts to expand patient protection. Several states have enacted medical debt laws in recent years, including Arizona, Colorado, Maryland and New York.
In North Carolina, a bipartisan group of legislators is pushing a bill that would limit some collection activities by hospitals, including caps on the interest rates health care providers can charge on patient debt and limits on collections from family members. Earlier this year, the state Senate unanimously passed a bill called the Medical Debt Disarmament Act.
But Charlotte’s CBS affiliate WBTV reports that the bill has stalled in the House due to opposition from the state’s dominant hospital industry. Since 2022, the hospital industry’s Political Action Committee has donated more than $260,000 to campaigns. Among the biggest beneficiaries of the hospital industry’s billions is North Carolina House Speaker and Republican Tim Moore, the bureau reports. Moore’s office did not respond to KFF Health News inquiries.
KFF Health News, a national news agency that produces in-depth journalism on health issues, is one of the KFF’s core operating programs and an independent source of health policy research, polls and journalism. is. Learn more about KFF here.