Income levels of bad-debt and free-care patients in Massachusetts hospitals

Health Affairs

Volumn 18, Issue 4, 1999, Pages 156-166

  Weissman, Joel S ^a   Dryfoos, Paul ^c   London, Katharine ^b  

^a HARVARD MEDICAL SCHOOL   (United States)

^b Massachusetts Div Hlth Care F   (United States)

^c NONE

Author keywords

[No Author keywords available]

Indexed keywords

ACCOUNTING; ARTICLE; ECONOMICS; HOSPITAL; HOSPITAL COST; HUMAN; INCOME; SOCIOECONOMICS; STATISTICS; UNITED STATES;

BOSTON; HOSPITAL COSTS; HOSPITALS, URBAN; HUMANS; INCOME; MEDICAL INDIGENCY; PATIENT CREDIT AND COLLECTION;

EID: 0033158789     PISSN: 02782715     EISSN: None     Source Type: Journal    
DOI: 10.1377/hlthaff.18.4.156     Document Type: Article

References (24)

1. U.S. General Accounting Office, Medicaid: Demographics of Non-Enrolled Children Suggest State Outreach Strategies, GAO/HEHS-98-93 (Washington: GAO, 1998).
2. T.M. Selden, J.S. Banthin, and J.W. Cohen, "Medicaid's Problem Children: Eligible but Not Enrolled," Health Affairs (May/June 1998): 192-200.
3. J.P. Clement, D.G. Smith, and J.R. Wheeler, "What Do We Want and What Do We Get from Not-for-profit Hospitals?" Hospital and Health Services Administration 39, no. 2 (1994): 159-178;
4. B. Gray, "The Performance of For-Profit and Nonprofit Health Care Organizations," in The Profit Motive and Patient Care (Cambridge, Mass.: Harvard University Press, 1991), 90-110;
5. LS. Lewin, T.J. Eckels, and L.B. Miller, "Setting the Record Straight: The Provision of Uncompensated Care by Not-for-Profit Hospitals," New England Journal of Medicine 318, no. 18 (1988): 1212-1215;
6. U.S. General Accounting Office, Report on Nonprofit Hospitals and the Need for Better Standards for Tax Exemption (Washington: GAO, 1990);
7. and J. Wolfson and S.L. Hopes, "What Makes Tax-Exempt Hospitals Special?" Healthcare Financial Management 48, no. 7 (1994): 56-60.
8. J. Weissman, "Uncompensated Hospital Care: Will It Be There If We Need It?" Journal of the American Medical Association 276, no. 10 (1996): 823-828.
9. Clement et al., "What Do We Want?;"
10. G. Atkinson, W.D. Helms, and J. Needleman, "State Trends in Hospital Uncompensated Care," Health Affairs (July/August 1997): 233-241;
11. J.M. Mann et al., "A Profile of Uncompensated Hospital Care, 1983-1995," Health Affairs (July/August 1997): 223-232;
12. E.S. Campbell, "Unpaid Hospital Bills: Evidence from Florida," Inquiry 29, no. 1 (1992): 92-98;
13. and H.P. Tuckman and C.F. Chang, "Who Bears the Burden of Uncompensated Hospital Care?" Journal of Health and Social Policy 1, no. 1 (1990): 9-20.
14. D. Schactman and S.H. Altman, "The Impact of Hospital Conversions on the Health Care Safety Net," in The Future U.S. Health Care System: Who Will Care for the Poor and Uninsured?, ed. S.H. Altman, U.E. Reinhardt, and A.E. Shields (Chicago: Health Administration Press, 1997), 189-206.
15. D. Burda, "Charity Care: Are Hospitals Giving Their Fair Share?" Modern Healthcare 22, no. 24 (1992): 1, 22-25, 28-29;
16. and The 1994 AHA Annual Survey of Hospitals, Estimated Version, U.S. Community Hospitals (Chicago: American Hospital Association, 1994).
17. A fourth type of Uncompensated care, medical hardship, is free care available to patients of any income who encounter very high medical bills, but its occurrence is extremely rare.
18. Unpublished data, Massachusetts Division of Health Care Finance and Policy.
19. Commonwealth of Massachusetts, Chapter 203 of the Acts of 1996, "An Act Providing for Improved Access to Health Care."
20. "Report of the Special Commission on Uncompensated Care," Massachusetts Senate Bill 1691 of 1997.
21. In Massachusetts ten hospitals received Medicaid DSH payments in 1996 by the following criteria: (1) More than 63 percent of the hospital's charges must be Medicare, Medicaid, other government programs of public assistance, and free care; and (2) the hospital's free-care charges as a percentage of total charges must be greater than the statewide seventy-fifth percentile.
22. "Report of the Special Commission on Uncompensated Care."
23. See GAO, Medicaid: Demographics of Non-Enrolled Children.
24. J.S. Weissman, C. Van Deusen Lukas, and A.M. Epstein, "Bad Debt and Free Care in Massachusetts Hospitals," Health Affairs (Summer 1992):148-161.