Erica L Eliason, Hannah MacDougall, Lauren Peterson
{"title":"Understanding the Aggressive Practices of Nonprofit Hospitals in Pursuit of Patient Debt.","authors":"Erica L Eliason, Hannah MacDougall, Lauren Peterson","doi":"10.1093/hsw/hlab034","DOIUrl":null,"url":null,"abstract":"<p><p>Nonprofit hospitals have attracted scrutiny for aggressive collection activities against patients, which persist despite the Patient Protection and Affordable Care Act's attempt to limit particularly egregious practices, called \"extraordinary collection actions\" (ECAs). This study examines the prevalence of ECAs and characteristics of nonprofit hospitals that reported this behavior as of 2016. Using Community Benefit Insight data, characteristics of hospitals that reported ECAs are compared with hospitals that did not report these practices. ECAs include reporting patient debt to credit agencies, filing lawsuits, placing liens on residences, and issuing civil arrest. Predictors of ECAs among nonprofit hospitals are identified using logistic regression analysis. The prevalence of ECAs is examined for the 2010-2016 time period, and nonprofit hospitals that reported ECAs are mapped to show the geographic distribution. Hospitals reporting ECAs significantly differed in total revenue, system membership, bed size, urban location, financial assistance policy use, and use of poverty guidelines for discounted care. In full logistic regression models, lower total hospital revenue was a significant predictor of ECAs. As social workers, it is vital to understand the landscape of nonprofit hospital collection actions to advocate for policy that protects patients from predatory practices while holding nonprofit hospitals accountable.</p>","PeriodicalId":47424,"journal":{"name":"Health & Social Work","volume":null,"pages":null},"PeriodicalIF":1.7000,"publicationDate":"2022-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Health & Social Work","FirstCategoryId":"90","ListUrlMain":"https://doi.org/10.1093/hsw/hlab034","RegionNum":4,"RegionCategory":"社会学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"SOCIAL WORK","Score":null,"Total":0}
引用次数: 0
Abstract
Nonprofit hospitals have attracted scrutiny for aggressive collection activities against patients, which persist despite the Patient Protection and Affordable Care Act's attempt to limit particularly egregious practices, called "extraordinary collection actions" (ECAs). This study examines the prevalence of ECAs and characteristics of nonprofit hospitals that reported this behavior as of 2016. Using Community Benefit Insight data, characteristics of hospitals that reported ECAs are compared with hospitals that did not report these practices. ECAs include reporting patient debt to credit agencies, filing lawsuits, placing liens on residences, and issuing civil arrest. Predictors of ECAs among nonprofit hospitals are identified using logistic regression analysis. The prevalence of ECAs is examined for the 2010-2016 time period, and nonprofit hospitals that reported ECAs are mapped to show the geographic distribution. Hospitals reporting ECAs significantly differed in total revenue, system membership, bed size, urban location, financial assistance policy use, and use of poverty guidelines for discounted care. In full logistic regression models, lower total hospital revenue was a significant predictor of ECAs. As social workers, it is vital to understand the landscape of nonprofit hospital collection actions to advocate for policy that protects patients from predatory practices while holding nonprofit hospitals accountable.
尽管《患者保护和平价医疗法案》(Patient Protection and Affordable Care Act)试图限制特别恶劣的做法,但非营利性医院针对患者的激进催收活动仍在继续,这一行为被称为“特殊催收行为”(eca)。本研究调查了截至2016年报告eca行为的非营利性医院的患病率和特征。使用社区福利洞察数据,报告eca的医院与未报告这些做法的医院的特征进行了比较。eca包括向信用机构报告患者债务、提起诉讼、对住所设置留置权和发布民事逮捕。采用logistic回归分析确定非营利性医院eca的预测因素。研究了2010-2016年期间eca的患病率,并绘制了报告eca的非营利性医院的地图,以显示其地理分布。报告eca的医院在总收入、系统成员、床位大小、城市位置、财政援助政策的使用和使用折扣护理的贫困指南方面存在显著差异。在全逻辑回归模型中,较低的医院总收入是eca的显著预测因子。作为社会工作者,了解非营利性医院收集行动的景观是至关重要的,以倡导保护患者免受掠夺性做法的政策,同时让非营利性医院承担责任。