Pennsylvania hospitals have doubled the average percentage of charity care they provide in the last eight years largely due to the increased use of presumptive eligibility tools, reports Pittsburgh Post-Gazette.
Presumptive eligibility tools use patients' credit histories, demographic information and even social media data to identify those individuals who qualify for charity care. The financial profiling technology enables hospitals to qualify some patients for charity care who otherwise would not or could not have completed a traditional charity care application.
This can positively impact hospital finances by reducing an organization's bad debt expenses. Presumptive eligibility tools effectively help prevent hospitals from taking on bad debt by reassigning some unpaid patient accounts as charity care.
UPMC Passavant in the North Hills and UPMC Mercy in Uptown implemented financial profiling tools in 2007. Between 2007 and 2014, UPMC Mercy and UPMC Passavant saw charity care levels rise 58.5 percent and 38.8 percent, respectively. Average charity care levels at hospitals statewide doubled between 2007 and 2015, according to data from the Pennsylvania Health Care Cost Containment Council.
However, some patient advocates are critical hospitals using presumptive eligibility technology often fail to notify patients they qualify for charity care. Critics have argued simply reclassifying an unpaid bill to charity care is not in spirit with charity care's legal purpose.
"What rubs me the wrong way about this is that it's not in the true nature of how we conceptualize charity care," Heather Klusaritz, PhD, senior fellow at the University of Pennsylvania's Center for Public Health Initiatives, told Pittsburgh Post-Gazette. "The goal of charity care is providing the comprehensive care that a patient needs, not just a single point-in-time encounter."