The nation's nearly 3,000 nonprofit hospitals collected billions in tax breaks but paid less than half that amount in charity care to low-income patients. In exchange for not paying income, property, sales or other taxes, these hospitals are expected to provide free or reduced-cost care to low-income patients as well as other community benefits. A new study estimates the enormous size of this collective tax break. The study reported the nation's nearly 3,000 nonprofit hospitals were spared $37.4 billion in federal, state and local taxes in 2021, a reflection of how lucrative these tax benefits can be for medical centers. Medicare filings show hospitals paid out $15.2 billion in charity care in 2021.
Within a few days of one another, two teams of accountants released separate estimates on the value of nonprofit hospitals' tax exemptions. Their wildly different findings underscore the degree to which who's counting and what they count matters. The first, a JAMA study published Thursday, pegged that number at $37.4 billion. It factored in the value of forgone federal and state income taxes, sales tax, property tax, federal unemployment tax, charitable contributions from donors, and savings from issuing tax-exempt bonds. The second, the AHA's annual snapshot of how hospitals' federal tax exemption compares to the benefits they provide their communities, included just three of the categories JAMA studied. The lobbying group's final number: $13.2 billion.
The Age-Friendly Hospital Rating is a new structural measure included in the CMS 2025 IPPS Final Rule. This measure is designed to assess hospitals' commitment to delivering high-quality care to patients 65 and older. The rating focuses on five key domains: patient goals, medication management, frailty screening, social vulnerability, and leadership commitment. Hospitals must affirmatively attest to these domains to demonstrate their compliance with best practices for older adults. The implementation of this measure includes specific data collection and submission requirements, as outlined by CMS. Hospitals are required to submit data for the Age-Friendly Hospital Rating measure on an annual basis. The data submission is structured around the five domains, and hospitals must evaluate whether they meet the criteria for each domain fully to receive credit.
Vermont's hospitals are in trouble. A new analysis found that the state's hospitals would need as much as $3 billion in subsidies — from commercial insurance increases or taxpayers — to remain solvent over the next five years, if immediate steps aren't taken. That figure comes from a 142-page report outlining a plan to radically transform the state's health care delivery system to bring down costs while continuing to provide access to care. The report was mandated by statute and put together by the consulting firm Oliver Wyman, whose team conducted a series of meetings with thousands of patients, health care workers, hospital leaders and advocates over the past year. Some of the headwinds facing the state's costly health care system: Commercial insurance rates are some of the highest in the country, and have increased by double digits for three years in a row, far outpacing the national average. Most of the state's 14 hospitals are operating at a loss, and those losses are expected to worsen in the coming years. Vermont's population is aging and shrinking, which will put further strain on the health care system and workforce. Patients face long wait times for primary care and specialty care and have inadequate access to community based services, leading to expensive, sometimes unnecessary hospital visits. Low-income households in rural areas face some of the greatest barriers to accessing care, stemming from a lack of affordable housing, transportation, and culturally competent care.
Atrium Health says it is wiping out all existing judgments and liens against patients for unpaid medical bills, offering relief to scores of North Carolinians who have been sued by the hospital system. "It's been a 20-year battle, like an albatross around my neck," said Terry Belk, a Charlotte patient with medical debt who has been an outspoken critic of Atrium's collection practices. "It has threatened to take everything I built up. It's been stressful — financially, mentally and somewhat physically — having this hanging over me." Belk, 68, said he has more than $40,000 in medical debt and a lien on his home related to breast cancer treatment for his wife, Sandra, who died in 2012, and his own more recent treatment for prostate cancer. He said he learned about the change after calling an Atrium vice president earlier this week. In North Carolina, medical debt judgments can last for 20 years and automatically place liens against patients' homes, allowing hospitals to collect their money when the home is sold. Medical debts also accrue 8% interest per year as long as they remain unpaid. Atrium's announcement comes amid growing pressure on hospitals nationwide to reform their debt collection and billing practices as the number of Americans struggling with medical debt soars. About one in five North Carolina residents has medical debt in collections, according to an Urban Institute analysis.
After temporarily suspending operations in May, Hicksville's Community Memorial Hospital (CMH) officially closed its doors at the end of August. Now, 13 Action News is learning the hospital allegedly stole nearly $3 million from its employees' retirement. "There are a lot of people who are really upset with the situation because four thousand people relied on this place," James Siler, who has been a patient at CMH for most of his life, said. "It's an inconvenience for sure. But there are a lot of people who have it a lot worse than me that's for sure." Siler's primary care physician, Dr. Vasavi Reddy, is one of only a handful of doctors still operating out of the hospital. Reddy is employed through the Parkview Health system. "Unfortunately, there's still a lot of instability in our practice location. Right now, Parkview is renting this space for me, but we don't know the future of the building," Reddy said.