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Hospital Accountability Project

For Americans without adequate insurance who can't afford to pay for health care, hospital community benefit programs can be a life-saving resource. Non-profit hospitals' obligation to provide community benefits including charity care, is rooted in their tax-exempt status. Taxpayers support these hospitals through tax breaks worth billions of dollars every year.  In exchange for this support, nonprofit hospitals are supposed to help their communities by working with them to identify and address the most pressing health care needs of the people they serve.  When these programs work properly, hospitals and communities partner to meet longstanding health needs.

Unfortunately, not all hospitals have been doing their fair share. Some fail to notify patients that charity care exists or provide it to those truly in need.  Others overcharge self-pay patients, require them to make significant upfront payments before allowing them to access care, use aggressive practices to collect debts; or ignore vital community health needs.

National health reform will provide coverage to millions of Americans, but effective hospital community benefit programs will still be critical to providing timely, affordable care and to addressing broader community health issues.


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Community Catalyst’s Hospital Accountability Project views hospitals as vital partners in our health care system. We work with consumer advocates, hospital leaders, and policymakers to improve institutional practices and promote public policies that set clear community benefit standards and establish strong consumer protections in hospital charity care, billing and debt collection.

We support state and local advocates with policy expertise, advocacy tools and services that help them assess institutional and systemic problems, educate and involve community members, and engage hospitals and policymakers in finding solutions that work for the people they serve. We are administering funds from a cy pres award from the court settlement of a major class action lawsuit against Tenet Hospital Corporation to coalitions of advocacy groups in 15 states. We also currently work to promote federal policies that would set fair minimum standards for charity care and community benefits, particularly for non-profit hospitals.

In 2010, The Access Project and Community Catalyst entered into a collaboration to explore new initiatives regarding medical debt, hospital charity care and issues related to billing and collection.