July 23, 1999

Study: more patients could qualify for free care

Practically all patients whose care in Massachusetts hospitals is reimbursed out of state free-care funds have incomes within the guidelines for such care, according to a report in the July/August issue of Health Affairs. However, contrary to a common belief that many patients whose expenses are written off as bad debt are able to pay their bills, the study of 1996 data found that the great majority of bad-debt patients had incomes that would have made them eligible for state-sponsored free care or Medicaid.

The report was written by Joel Weissman, PhD, of the MGH Institute of Health Policy, Paul Dryfoos, MBA, a Boston-based health care consultant and former Massachusetts deputy state budget director, and Katharine London of the Massachusetts Division of Health Care Finance and Policy (DHCFP).

"We found that a lot of care written off to bad debt is delivered to patients who are actually quite poor, which has potentially serious implications, since these patients may be reluctant to obtain treatment in the future if they fear being billed for services they cannot afford," says Weissman, the report's lead author. "This information, along with some public policy changes, has prompted many hospitals in the state to set up programs to identify all uninsured patients who might be eligible for free care or for Medicaid programs."

One such initiative is the Health Insurance Access Program, which was set up last year to match uninsured patients with programs offering health cost coverage
(see January 22, 1999 issue of Hotline).