Hidden Lifelines: Arizona’s Hospital Financial Assistance Programs
Anthony Robinson, a 44-year-old resident from Arizona, was bewildered to find himself facing hospital bills amounting to more than $8,000 for his kidney stone treatment, even after insurance coverage was applied. As he pondered over his financial adjustments, a lifeline came in the form of Dignity Health’s financial assistance program.
Unaware of the charity care policies that hospitals often offer, Robinson reached out to Dignity Health to explore potential support options. To his surprise, after submitting a financial assistance application in December, his entire outstanding balance was waived by January. “To get 100% of a bill is a blessing,” Robinson remarked.
In compliance with Section 501(r)(4) of the Internal Revenue Code, nonprofit hospitals like Dignity Health are mandated to maintain written financial assistance policies. This requirement, instituted by the Affordable Care Act in 2010 and refined in 2014, ensures essential medical services are accessible without financial burden.
Arizona hospitals collectively forgave over $324 million in charity care in 2024, as per a report by the Arizona Health Care Cost Containment System. The report highlights that charity care is a component of the broader category of uncompensated care, which has seen a significant increase of $213.2 million since 2015.
James Hodge from Arizona State University’s Sandra Day O’Connor College of Law warns that with Medicaid policy changes pending, a growing number of Arizonans may depend on hospital financial assistance. “We’re going to be needing considerably greater charity care for the long term if we’re even remotely going to provide care for Arizonans,” Hodge stated.
Both nonprofit and many for-profit hospitals extend charity care to qualifying uninsured or under-insured patients. These policies, however, differ based on factors such as income level, household size, and the age of the bill. Eligibility may also depend on residency, citizenship status, and whether the care was provided in-network.
Ann-Marie Alameddin, president and CEO of the Arizona Hospital and Healthcare Association, points out that while the ACA standardized charity care, hospitals have long been offering reduced or free care. “It’s really a part of the hospital’s mission to care for their communities, no matter someone’s ability to pay,” Alameddin explained.
Despite federal mandates for hospitals to “widely publicize” financial assistance programs, a 2023 survey by Dollar For revealed that 51% of potentially eligible individuals did not apply for such assistance. Over half of these individuals were unaware of the available financial help.
Dollar For’s founder, Jared Walker, emphasizes the need for better patient education on financial assistance options. “A lot of patients leave the hospitals without knowing about the program at all,” Walker said, suggesting hospitals could enhance awareness efforts.
Alameddin notes that financial assistance policies and forms are accessible in Arizona hospitals and online, often discussed during healthcare interactions. However, with looming Medicaid cuts and the expiration of ACA enhanced premium tax credits, the number of uninsured Arizonans is expected to rise.
According to Hodge, this increasing demand for assistance coupled with shrinking hospital revenues could lead to difficult decisions for smaller, rural hospitals in Arizona. “They start cutting the services they can that are the least profitable or least serviceable possible,” Hodge cautioned, highlighting the potential for service reductions or even closures.
Walker from Dollar For encourages individuals to check their eligibility for financial assistance, noting, “A lot of times people just assume that they’re not eligible. They kind of disqualify themselves.”
This article first appeared on Cronkite News and is republished here under a Creative Commons Attribution-NoDerivatives 4.0 International License.
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