So far this year, hardly a week goes by without an article or report on egregious actions by nonprofit hospitals. While the actions aren’t new, several factors have combined in 2023 to raise the level of scrutiny.
Hospitalfinances.org, a site AHCJ launched in 2018 to provide free, searchable financial information on nonprofit hospitals across the United States, is back online after a year-long hiatus.
“Hospitalfinances.org was designed to give the most useful parts of the IRS Form 990 to journalists with a few clicks,” said Karl Stark, a former AHCJ board president who worked with Jeff Porter, former director of education, to help build the site in 2018.
Kaiser Health News and Capital News Service have been publishing a series called “Baltimore’s Other Divide” – the state of health in a city which has vast disparities in health status, and some of the country’s best known hospitals.
The latest installment, by Jay Hancock, Rachel Bluth and Daniel Trielli, focuses on asthma “hot spots.” Drawing on rich hospital data, they identified the worst places for asthma in the city – ZIP code 21223. People there, like 9-year-old Keyonta Parnell, go the emergency room more often, and call 911 more often. The hospitals know that. But it’s not in their financial interest to fix it. Continue reading
AHCJ New York members gained a unique look this week into how journalist, author, and businessman Steven Brill researched and compiled his now-infamous 36-page Time Magazine article “Bitter Pill: Why Medical Bills Are Killing Us.” The article took a hard look at the costs of hospital care in the United States – from the $70 box of gauze pads to a $50,000 up-front payment demand by one top cancer facility before doctors there would even evaluate a terminally ill patient.
That March 4 opus added fuel to an already contentious debate about the skyrocketing cost of U.S. health care. Brill emphasized the huge price discrepancies between what it costs hospitals and what they charge Medicare, private insurers, and direct-billed patients for identical care. “It was really a question of just doing some math,” he said.
Brill detailed his efforts to get satisfactory explanations from hospital CEOs about their multimillion dollar salaries while someone who had no health insurance was paying perhaps hundreds of dollars for a product that could be purchased in a local drugstore for pocket change. He explained how he obtained copies of actual hospital bills – for hundreds of thousand of dollars in some cases – and how he tracked down and analyzed the price differentials charged to public, private and non-insured patients. Continue reading
Writing in the Contra Costa Times, Sandy Kleffman reports that while nonprofit hospitals in the East Bay are given millions in tax breaks, “The responsibility of caring for the indigent falls largely on the region’s public hospitals.”
Kleffman’s findings are based on her analysis of publicly available California Office of Statewide Health Planning and Development reports, documents which she learned to access and process at a September webinar led by AHCJ board president and ProPublica senior reporter Charles Ornstein.
Her analysis revealed a substantial imbalance in the numbers, especially between public hospitals and nonprofits. For example, Contra Costa’s county hospital provided more than three quarters of the total amount of charity care given in the country in 2010, while the six nonprofits together accounted for just under 23 percent.
For their part, representatives of nonprofit hospitals protested that the numbers do not take into account the other community benefits they provide, nor are they adjusted to compensate for the differences in demographics across each institution’s patient pool.
For more on what went into Kleffman’s report, see her sidebar on “How we made comparisons.”