Recent reports of aggressive debt collection by the University of Virginia Medical Center deliver a black eye to the university.
The reports by Kaiser Health News and The Daily Progress detail the stories of people who were forced into bankruptcy, marriages that crumbled under the stress of debt collection, and education plans put on hold as the Medical Center even went after UVa’s own students.
To be fair — and as the university says in its defense — state law requires that the Medical Center do its best to collect debts. It’s a public hospital that receives state and federal tax breaks in return for treating low-income patients via Medicaid. The General Assembly does not want to be called upon to pour even more tax money into public entities such as UVa, so it requires them to be insistent about collecting monies owed them.
But Kaiser found that UVa’s rules for forgiving debts and tactics for collecting debts were more aggressive than any other hospital in the state, with the exception of those applying at Virginia Commonwealth University, home to another state-supported hospital.
UVa’s practices also were more aggressive than most of the peer hospitals to which it was compared nationally.
Many of the patients UVa sued for nonpayment of debt were those who couldn’t afford good insurance plans, yet were not poor enough to qualify for Medicaid.
The debt collection crusade therefore hit patients who were particularly vulnerable — and at a time when national health care and insurance systems were being restructured in ways that often caught families off guard, unable to afford insurance plans that might have helped pay their bills.
Kaiser’s report also detailed instances in which the UVa Medical Center charged far more for care than would have been allowed under many insurance plans.
The university said it needed the money “to generate positive operating income” to invest in medical education, new facilities, research and the latest technology, according to the Kaiser story first published in The Washington Post.
All these things benefit not only UVa, but the entire Charlottesville-Albemarle community, bringing in jobs and other economic activity. And they benefit not only the local community, but the nation and the world: Medical staff trained here go on to help millions of people over time; research breakthroughs generated here help millions more.
A hospital spokesman also said that the center doesn’t file lawsuits against non-paying patients until numerous bills have been ignored, and that it works with patients whenever possible to set up payment plans.
The Medical Center should keep in mind that its primary priority is delivering patient care — and that should include efforts to provide care to as many people as possible as inexpensively, but effectively, as possible.
For a university striving, under new President Jim Ryan, to be a model of socially responsible education and leadership, this is a damaging setback.
The university already has modified its approach somewhat, deciding in 2017 to sue only patients owing more than $1,000.
And President Ryan says UVa now is reviewing its other practices for collecting debts. The president learned last month of the extended use of lawsuits to collect debts, according to a university post on social media.
Revisions to those practices are expected to be announced tomorrow.
Those changes should address a variety of issues:
» Offering more sensible rules under which patients can receive financial assistance. Other Virginia hospitals have more lenient eligibility rules for assistance: why not UVa?
» Pricing services more realistically, so that charges to patients are more in line with insurance pricing — even for patients who don’t have a good insurance policy to protect them.
» Ensuring that no student’s education will jeopardized by illness — even if the university has to raise private money to establish a fund for paying student medical bills as needed.
Of course, we and the rest of this community want the UVa Medical Center to thrive. To do so, it needs to be fairly compensated for the services it provides.
But the Kaiser report raises serious questions about whether UVa’s charges to patients, and its pursuit of patients, are in fact fair. But this challenge also provides an opportunity for the university to make good on President Ryan’s goal for it to be “not just great, but good” — that is, to have heart and soul.
We look forward to Friday’s unveiling of new policies in hopes that the Medical Center can return to its reputation of a provider of nurture and healing, and put behind it its newly gained reputation as persecutor.