The medical debt capital of the world is…
Noam N. LeveyAlmost everything about the opening of the 2019 Prosper High School Eagles' football season was big.
A KHN review of hospital finances in the country's 306 hospital markets found that several of the most profitable markets also have some of the highest levels of patient debt. Zipprich, 64, had spent a career in financial consulting. He owned a small bungalow in a historical neighborhood near the Fort Worth rail yards. His daughters, both teachers, and his four grandchildren lived nearby. He had health insurance and some savings, and he'd paid off his mortgage.
Overall in Tarrant County, 27% of residents with credit reports have medical debt on their records, credit bureau data analyzed by KHN and the nonprofit Urban Institute shows. In Dallas County, it's 22.5%. Angie Johnson of Waxahachie, Texas, cut short her honeymoon so that she and her husband could pay off more than $1,100 she owed a physical therapy center owned by a Dallas-based hospital system.
Unlike drug companies, device makers, and many physician practices, most U.S. hospitals are nonprofit and must provide charity care as a condition of their tax-exempt status. When Texas Health Resources, a Dallas-based nonprofit system with more than $5 billion in annual revenue, opened a new hospital tower in Fort Worth earlier this year, Barclay Berdan, the system's chief executive, said the building"reinforces Texas Health's long-standing commitment to the Fort Worth community." The nine-story, $300 million tower is one of more than a half-dozen new hospitals and major expansions around the Dallas-Fort Worth area since 2018.
The average margin at hospitals in and around Gainesville and Lakeland, two central Florida markets where a quarter of residents also carry medical debt, topped 9%. In Tulsa, Oklahoma, which has the same level of debt, margins have averaged 8.5%. One key is prices. These hospitals maximize what they charge for everything from a complex surgery to a dose of aspirin. Most of those charges are picked up by health insurers, which still pay a much larger share of hospital bills than patients do, even those with the highest deductibles.
As bills rise, hospitals are having a harder time collecting. Last year, nearly 1 in 5 patient bills generated by hospitals for people with insurance topped $7,500, according to anby Crowe LLP, a Chicago-based accounting and consulting firm. That was more than triple the rate in 2018.
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