Report Grades Hospitals on Predatory Patient Billing Practices

Many of the top hospitals in America use predatory patient billing practices, and new data from Johns Hopkins University (JHU) is ranking these hospitals based on their use of these tactics.

The JHU analysis shared with Axios found that over a quarter of the top 100 US hospitals according to revenue sued patients over unpaid medical bills between January 2018 and July 2020. What’s more, just ten hospitals on that list were responsible for 97 percent of court actions against patients during that time.

For example, VCU Medical Center in Richmond, Virginia was responsible for 17,806 of the 38,965 court actions all hospitals took against patients over unpaid medical bills during the period. University Hospital, also in Virginia, was also one of the top hospitals with the most court actions (7,107), followed by Froedtert Hospital in Wisconsin (3,278).

The court actions not only included lawsuits, but also wage garnishment and personal property liens against patients for unpaid medical bills.

Notably, VCU Medical Center is a governmental hospital and both University Hospital and Froedtert Hospital are non-profit organizations. In general, governmental and non-profit hospitals were the most likely to file lawsuits against patients, the JHU analysis showed.

“[I]f it’s not a violation of the letter of the Affordable Care Act law, it’s certainly a violation of the spirit of it,” Marty Makary, a lead JHU researcher, told Axios.

These predatory patient billing practices did slow a little by 2020 when the COVID-19 pandemic hit. In fact, fewer court actions were taken against patients by hospitals compared to the previous two years, Axios reported.

Some hospitals, including VCU Medical Center and University Hospital, also stopped suing patients over the last couple of years.

“We are committed to providing high-quality, compassionate care to all community members and these new policies and practices uphold our commitment,” Douglas E. Lischke, the CFO of UVA Health, which operates University Hospital, said in a statement earlier this year after the system announced in will drop all lawsuits against lower-income patients.

But researchers were still unsure how much the decrease in court actions against patients is attributable to the pandemic and how much is tied to lasting patient billing changes.

Still, most hospitals did not engage in predatory patient billing practices during the period, JHU researchers found. According to their rankings, hospitals with the best predatory billing grade, meaning they did not take court action against patients, included:

• NYU Langone Tisch Hospital in New York, New York (A)
• Stanford Hospital in Stanford, California (A)
• New York Presbyterian in New York, New York (A)
• Cedars-Sinai Medical Center in Los Angeles, California (A)
• AdventHealth Orlando in Orlando, Florida (A)
• The Cleveland Clinic in Cleveland, Ohio (A)
• UCSF Medical Center at Parnassus in San Francisco, California (A)
• UPMC Presbyterian in Pittsburgh, Pennsylvania (A)
• Montefiore Hospital – Moses Campus in Bronx, New York (A)
• Vanderbilt University Hospital in Nashville, Tennessee (A)

Hospitals with failing predatory patient billing grades between 2018 and mid-2020 included:

• The University of Kansas Hospital in Kansas City, Kansas (F)
• University of Kentucky Albert B. Chandler Hospital in Lexington, Kentucky (F)
• University Hospital in Charlottesville (F)
• Long Island Jewish Medical Center in New Hyde Park, New York (D)
• NYU Winthrop Hospital in Mineola, New York (D)
• Norton Hospital in Louisville, Kentucky (D)
• North Shore University Hospital in Manhasset, New York (D)
• Memorial Regional Hospital in Hollywood, Florida (D)
• Westchester Medical Center in Valhalla, New York (D)
• Mayo Clinic Hospital – St. Mary’s Campus in Rochester, Minnesota (D)

For full rankings, click here.