Hospitals Accused of Hounding Patients With ‘Predatory Billing’

A joint project by Johns Hopkins University and Axios concludes that “many of the top 100 hospitals by revenue in the U.S. use predatory tactics to pursue patients with unpaid bills,” referring to filing lawsuits against individuals who do not pay their medical debts.

Ten hospitals are responsible for 97% of court actions against patients, according to the report, which says that “patient lawsuits are more prevalent among governmental and nonprofit hospitals.”

Each of the 100 largest hospitals across the country was ranked according to a number of metrics, including the quality of their billing, how predatory their billing was, rating their charity care programs, and the average amount that they marked up their bills. Three hospitals — the University of Kansas Hospital, University Hospital in Charlottesville, Va., and University of Kentucky Albert B. Chandler Hospital — were the only facilities to receive “F” grades for their predatory billing practices, which were calculated using the number of lawsuits filed by the hospital, as well as the number of wage garnishments and property liens assessed against individuals with unpaid medical debts.

Between 2018 and 2020, hospitals filed 39,000 lawsuits seeking to recover $72 million, according to the analysis. The amount of medical debt makes up a “small sliver” of a hospital’s total receipts — about 0.03% in some cases — but “can cause devastating financial burdens to working families,” according to a report.

“Most hospitals do not engage in this form of predatory billing. But for the ones that are, it threatens the great public trust in the medical profession,” said Marty Makary, a lead researcher of the project, in a published report.

In a statement, a spokesperson for the American Hospital Association said that lawsuits were always a “last resort” and that hospitals’ doors are “always open” but the reality is “that the health care system must be adequately financed to ensure that hospitals and health systems are able to stay open and be there for their communities in times of need.”

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