The Structure of Hospitals’ Provision of Financial Assistance

• In Event: 3552 - Health Policy

Abstract

The rapidly changing health policy landscape promotes research of how nongovernmental healthcare organizations, such as hospitals, provide financial aid to patients. Previous research has studied hospitals’ provision of uncompensated care as a measure of the dollars for which the hospital expects no reimbursement. This paper prioritizes financial assistance for patients by shifting focus to charity care, defined as monetary assistance provided to patients who cannot pay their bills. This paper also challenges the commonsense assumption of how hospitals decide which patients cannot pay their bills. Using data from the Healthcare Cost Report Information System and the Californian Office of Statewide Health Planning and Development (N = 121), this paper investigates the assumption that hospitals idiosyncratically determine eligibility thresholds for charity care. The results of this paper identify ownership status as a core factor that structures the field of hospital financial assistance. Non-profit hospitals create higher eligibility thresholds for charity care, and they award more charity care dollars than for-profit hospitals. This study adds to theoretical discussions of the dominant logic guiding the healthcare field. It also provides hospital administrators and policymakers with a bird’s-eye view of the systematic variation in hospitals’ provision of financial assistance in a health policy context with weakened governmental support programs.

Author

• Clayton Thomas, Indiana University