Report details barriers to affordable care, pricing at metro Atlanta hospitals

Many metro Atlanta hospitals aren’t doing enough to improve health care accessibility for the low-income and uninsured, according to a report recently released by Georgia Watch. In addition, only half of the 34 hospitals in the 21-county Atlanta area fail to post legally-required signage about available financial aid programs, and most charged significantly marked-up prices.

The findings are the result of an 18-month study through the organization’s Metropolitan Atlanta Hospital Accountability Project, or HAP, which focuses on financial aid programs for low-income, uninsured and underinsured patients at general hospitals in the 21-county metro area. National nonprofit advocacy organization Community Catalyst, a national not-for-profit, provides funding for this project.

In its research, Georgia Watch representatives visited all hospitals studied to see if signage was posted advertising the availability of free or reduced cost care, and if financial assistance policies were made available to the public. In addition, the HAP team surveyed 900 low-income, uninsured, or underinsured individuals about their financial experiences at area hospitals. HAP collaborated with coalition partners WonderRoot, Concerned Black Clergy and area clinics to conduct the interviews, which were conducted in both English and Spanish.

Among the findings of the research:

• In 2008, metropolitan Atlanta hospitals marked-up their costs an average 235 percent increase, though price hikes at some facilities reach as high as 714 percent;
• That year, the two most expensive hospitals in the metropolitan area were North Fulton Medical Center and Cartersville Medical Center, and the two most affordable were Walton Regional Medical Center and Grady Memorial Hospital;
• Grady Memorial Hospital and Barrow Regional Medical Center provided the highest level of free care for poor people, while Piedmont Hospital and North Fulton Medical Center were among those who provided the least;
• Only a little more than one-third of the 34 hospitals examined had clear signage placed at some part of the hospital advertising the availability of free or reduced-cost care for uninsured and/or low-income persons;
• Eighty percent of the approximately 900 consumers surveyed for this project said they had no form of insurance, and two-thirds of those individuals said they had no regular source of care; and,
• 72 percent of the consumers surveyed who identified themselves as underinsured said they often delay preventive and other care due to the fear of the cost, as they are uncertain whether they can pay their part of a hospital bill.

“Hospitals owe to their communities access to care and fair billing practices, no matter your income level,” said Holly Lang, Hospital Accountability Project Manager. “Through programs that help lower barriers to health care access and by advertising the availability of available financial assistance, hospitals give consumers the chance to better their physical – and fiscal – health.”

While all hospitals should maintain the patient’s best interest, the report discusses the unique obligations of nonprofit hospitals, which are obligated through their tax-exempt status to provide services meant to boost its area’s health through community benefit programs.

“Nonprofit hospitals have an even heightened responsibility to its community, as they are exempt from many of the taxes most companies and individuals pay,” Lang said. “We want to see these hospitals using our forgone tax dollars in a way that helps all patients, especially those vulnerable because they are uninsured, underinsured or live on a limited income.”

Nonprofit hospitals Piedmont Hospital and Henry Medical Center stood out among area hospitals for providing the least amount of free care – less than a fourth of what a nearby for-profit hospital provided.

The report also notes the barriers that patients are facing once they step into a hospital.

“Too many facilities aren’t mentioning available financial aid programs, and many don’t have staff on hand to serve non-English speaking patients,” Lang said.

Also detailed in the report are policy recommendations for hospitals and lawmakers, including increased oversight of hospitals participating in state and federal programs,  appropriate financial counseling and fair patient billing practices.

Click here to read the Metropolitan Atlanta Hospital Accountability report.