Health care systems across the country talk about their commitment to their patients’ physical and emotional well-being. Most believe that their mission ends there.
Virginia Commonwealth University Health System knows that a patient’s financial well-being matters, too. In fact, large debts can undermine a patient and family’s physical and emotional health. As The Roanoke Times recently wrote in an editorial that appeared in the Richmond Times-Dispatch, data from RIP Medical Debt — a New York-based nonprofit — shows that 66% of U.S. bankruptcies are tied to medical debt. A quarter of all credit card debt is medical-related.
This type of debt is crushing and unsustainable for our patients and country.
That is why VCU Health System proactively implemented compassionate, innovative policies to help our most financially vulnerable patients and their families with their finances. Today, we do not pursue billing for our patients with incomes under 200% of the federal poverty level (roughly $25,000 for an individual or $51,500 for a family of four).
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Even if deemed ineligible for the commonwealth of Virginia’s indigent care program, these patients never receive a bill from us.
Almost two years ago, VCU Health System overhauled its institutional billing processes and stopped sending delinquent accounts to court to pursue debt collection. We also discontinued seeking garnishments of wages or placing liens on homes.
We didn’t stop there. In 2019, we started going court by court across the commonwealth to release any financial judgments against poor patients. Some of these liens had been in place for 20 years. Today, we successfully have canceled nearly 80,000 past judgments.
Why did we do this? Because it was the right thing to do. A health crisis should not lead to a financial crisis that follows patients for years.
As a result of these actions, VCU Health System has been noted as a leader in bringing financial security and affordability to those whom we serve.
In a 2020 article that appeared in the Richmond Times-Dispatch, Kaiser Health News quoted a Georgia State University law professor who is an expert in hospital billing as saying that VCU Health’s changes will “… relieve patients of an incredible financial and emotional burden.”
In addition to these actions, earlier this year, VCU Health System launched an online price transparency self-estimator tool for patients to supplement our already established hotline at: (804) 828-0966
These allow patients to get a personalized estimate of their likely out-of-pocket cost for a needed health care service, based on their insurance coverage. We also provide estimates to uninsured patients of their options for financial assistance.
At VCU Health System, a nonprofit health system established by and for the commonwealth of Virginia, our mission is to serve patients, their families and Virginia’s communities — not to make a profit and generate a return on investment for shareholders. We must generate enough revenue from public, private and philanthropic sources to sustain our system, but we do not and will not exploit patients.
Over the past several years, we’ve made great strides to alleviate the financial burden that providing lifesaving care can place on patients and their families. Going forward, we will continue to explore ways to preserve and protect not only our patients’ physical and emotional health, but their financial health as well.
Art Kellermann, M.D., is senior vice president of health sciences and CEO of VCU Health System. From 2000 to 2004, he co-chaired the Institute of Medicine’s (now the National Academy of Medicine) Committee on the Consequences of Uninsurance. Contact him at: vcuhealthceo@vcuhealth.org