Comparison of US hospital charity care before, after COVID-19

Editor's Note

This study from the University of South Carolina, Columbia, and Johns Hopkins, Baltimore, finds that between December 2019 and December 2021, nearly one-third of large, tax exempt hospitals improved their charity care policies.

Across the 2-year period, 127 of 151 (84.15) hospitals updated their policies, and 77 (51.0%) made substantial changes.

Of 242 distinct policy changes, 135 were more generous, 46 were more restrictive, and 61 were indeterminate.

Specific policy changes mostly involved:

• income cutoffs for free and discounted care
• residency status
• presumptive eligibility
• duration of coverage
• underinsured eligibility.

The findings suggest that greater transparency and simplification in charity care policies are needed to ensure adequate access to charity care, the authors say.