Advocates, lawmakers push hospitals to help more with bills

Swamped with medical bills? The hospital that treated you may be able to help.

Whether you learn about this before those bills wind up in debt collections is another matter.

Medical bills often represent large, unexpected shocks that can crash personal budgets. Roughly 1 in 7 U.S. residents with a credit record has medical debt in collections, according to the nonprofit Urban Institute.

Hospitals have ways to keep more people from joining those ranks. Those can include income-based discounts, payment plans, help finding health insurance or waiving a bill and writing it off as charity care.

But people frequently miss notices in their bills about assistance or have trouble plowing through the paperwork to qualify, patient counselors say. They say hospitals need to do more to ensure patients know about available help.

“We need a whole new mindset,” said Elisabeth Benjamin, a vice president with the nonprofit Community Service Society of New York. “A hospital’s a charity ... (it) should be figuring out why a patient isn’t able to pay a bill.”

The Affordable Care Act requires nonprofit hospitals to tell patients about financial help, but it leaves the details for how that gets done or the extent of the assistance largely up to them. Patient counselors see little consistency.

Hospitals say they often notify patients several times about available help. They’ve also eased income limits for assistance during the COVID-19 pandemic, and some have smoothed out cumbersome applications.

But it can be hard to identify everyone who needs help, said Rick Gundling, a senior vice president with the Healthcare Financial Management Association, which consults with hospitals.

“I think many times when the patient doesn’t have the money, they retreat or they don’t ask for help, when the...