{"id":179186,"date":"2025-06-12T19:53:12","date_gmt":"2025-06-12T19:53:12","guid":{"rendered":"https:\/\/www.europesays.com\/uk\/179186\/"},"modified":"2025-06-12T19:53:12","modified_gmt":"2025-06-12T19:53:12","slug":"us-medical-debt-financing-groups-vie-to-be-solution-to-struggling-rural-hospitals-us-healthcare","status":"publish","type":"post","link":"https:\/\/www.europesays.com\/uk\/179186\/","title":{"rendered":"US medical debt financing groups vie to be \u2018solution\u2019 to struggling rural hospitals | US healthcare"},"content":{"rendered":"

Medical debt financing and \u201cpatient access\u201d companies are pitching their services to struggling rural hospitals nervous about keeping the doors open, as congressional Republicans consider healthcare cuts that could leave 16 million Americans<\/a> without insurance.<\/p>\n

These companies, who act as middlemen between hospitals and patients, told the Guardian they could be a solution for cash-poor hospitals seeking to get paid by \u201csubprime patients\u201d \u2013 especially the low-income, uninsured and unbanked.<\/p>\n

\u201cThese guys are losing money \u2013 it\u2019s not sustainable,\u201d said Chris Stenglein, CEO of Curae, about hospitals and healthcare providers. Curae is a company that charges hospitals a fee to find money from all sorts of sources \u2013 including patients.<\/p>\n

\u201cI believe the next huge bailout is going to be health systems.\u201d<\/p>\n

Middlemen are nothing new to American healthcare \u2013 the Commonwealth Fund found that the administrative complexity of US healthcare accounts for nearly one-third<\/a> of the sky-high<\/a> price of care in the US.<\/p>\n

What is new is the potential market disruption created by Republicans<\/a>. A bill passed by House Republicans before Memorial Day would cut Medicaid by $804bn and Obamacare, formally known as the Affordable Care Act, by $301bn \u2013 changes in Republicans\u2019 \u201cbig, beautiful bill\u201d that are expected to result in 16 million newly uninsured Americans by 2034. That disruption represents risk for hospitals and patients, but an opportunity for business.<\/p>\n

\u201cThis really underscores the through line between Medicaid cuts today equal medical debt tomorrow,\u201d said April Kuehnhoff, a senior attorney at the National Consumer Law Center (NCLC). \u201cThis is really going to harm the most vulnerable patients in the United States.\u201d<\/p>\n

Hospitals face a real risk of not staying afloat: margins at the nation\u2019s roughly 3,000 non-profit hospitals, about half of all nationally, reached an eight-year low in September 2023, according to a recent report from the consulting firm Deloitte<\/a>. Operating margins were just 0.8% on average that year.<\/p>\n

\u201cProviders carry more consumer paper than all of your regional banks combined,\u201d said Stenglein, referring to consumer debt. \u201cIn some cases, they got $1.3bn they write off every year.\u201d<\/p>\n

Stenglein views himself as a good guy in this fight, working in a \u201cdysfunctional\u201d system to help people like his own parents. His mother worked at the grocery store chain Winn Dixie and his father was a truck driver. Started eight years ago, Curae is now a subsidiary<\/a> of Atlanticus Holdings Corporation, which owns a portfolio<\/a> of credit cards for subprime borrowers. The publicly traded corporation is valued at $794m<\/a>.<\/p>\n

Firms like Curae offer an appealing pitch to hospitals, finding money from every conceivable source, such as insurers, discount drug programs, philanthropy and patients.<\/p>\n

But none of these services are free. Like the back end of a credit card, Curae charges hospitals a \u201cprocessing fee\u201d of up to 6% for every transaction, Stenglein said in an interview. In written questions, Curae later declined to confirm its processing fee rate, stating: \u201cOur program management fees are confidential.\u201d<\/p>\n

Curae also facilitates financing to patients, specializing in payment plans and interest-bearing loans to patients who are \u201chigher risk\/subprime patients, who usually would never get approved for any sort of credit\u201d, a spokesperson told the Guardian. Curae is not a lender, but brands loans through the Bank of Missouri. The spokesperson said Curae-branded loans are available to patients who would struggle to \u201ceven be approved for other loans such as for cars\u201d.<\/p>\n

However, Curae does not refer patients, including the marginalized consumers the company specializes in, to non-profit hospitals\u2019 charity care programs. \u201cNo, the hospital administers that program,\u201d the company said in written questions.<\/p>\n

Curae-branded loans are 0% interest for patients up to 24 months. Longer-term loans cost between 9.9% and 36% based on creditworthiness for longer terms, according to a June 2021 cardholder agreement<\/a>. Stenglein said only 3-4% of the \u201cpatient population\u201d sign up for interest-bearing loans, which together with payment plans represent about one-fifth of the business.<\/p>\n

A more recent cardholder agreement provided by Curae showed a long-term APR of 14.99%, although the cardholder agreement represented an approved rate for one individual borrower, and not the full range of possible rates.<\/p>\n

Some patients have lodged complaints about this system publicly, including an Arizona teacher who said she was \u201cinfuriated<\/a>\u201d when she was signed up for a credit card without her knowledge.<\/p>\n

\u201cI got a hit on my credit saying somebody did a hard look at my credit, and of course I was freaking out, like what is going on?\u201d Kerry Morgan told local TV station AZFamily<\/a>. \u201cCome to find out, it was Banner [Health]\u201d a non-profit hospital system that partners with Curae, \u201chit my credit and signed me up for a credit card to put the payments on\u201d.<\/p>\n

Despite fees hospitals must pay on top of already low margins, and the potential for patient complaints, some providers still find the deal enticing.<\/p>\n

\u201cHospitals simply do not have the sophisticated skill to squeeze money out of patients,\u201d said Ge Bai, a professor at Johns Hopkins Carey Business School and a healthcare accounting expert.<\/p>\n

\u201cWe\u2019re going to see more and more businesses like that that help hospitals enhance revenue. You\u2019re already seeing a flourishing, thriving industry,\u201d of financial middle men.<\/p>\n

A testimonial sent to the Guardian by Curae provides a window into this appeal: a Banner Health employee said Curae helped the hospital \u201cimprove collections\u201d at the \u201cpoint of service\u201d (their healthcare facilities) \u201cby $22m compared to 2023\u201d. More than 90,000 patients applied for financing with Banner in 2024.<\/p>\n

\u201cI\u2019ve worked in the field of Patient Access [sic] for 22 years,\u201d wrote Jarrod Brown, senior director of patient access at Banner Health. \u201cCurae has been a major win for our patients, by providing a financing option focused on their healthcare needs.\u201d<\/p>\n

Kuehnhoff said Curae\u2019s specialism in the \u201csubprime patient\u201d, calls into question whether hospitals are pushing patients who might be eligible for free or discounted care \u2013 known as \u201ccharity care\u201d \u2013 into payment plans.<\/p>\n

\u201cDoes this person who needs medical financing actually qualify for charity care through the hospital? And are they being shunted to a medical financial product rather than appropriately given the assistance they qualify for?\u201d Kuehnhoff asked rhetorically.<\/p>\n

Traditionally, hospitals have provided patients with interest-free payment plans and the majority still do. A recent research letter published in Jama Health Forum<\/a> found only 8.5% of hospitals promote what the study described as \u201cinterest-bearing\u201d payment products.<\/p>\n

\u201cHospitals have really tried to step up to offer long-term payment plans for at least some of the patients within some income brackets \u2013 to try to work with people,\u201d said Erin Duffy, a scholar at the University of Southern California\u2019s Schaeffer Institute and a co-author of the study.<\/p>\n

But insurers have increasingly pushed costs<\/a> on to consumers, which has forced hospitals to collect directly from patients.<\/p>\n

By 2022<\/a>, medical debt was the most common form of debt in collections, according to the Consumer Financial Protection Bureau (CFPB), and most patients in debt to hospitals were insured, according to a widely cited report<\/a>. The same year, about one-quarter<\/a> of American adults said they had a past due medical or dental bill, according to a survey by Kaiser Family Foundation.<\/p>\n

Before Trump entered office, the Biden administration attempted to prevent debt collectors from reporting medical debt to credit agencies as a form of relief \u2013 efforts debt collectors fought and that abruptly ended<\/a> with the gutting<\/a> of the CFPB.<\/p>\n

\u201cI don\u2019t think we want to make a case that these are evil companies because at the end of the day they did increase access for some patients on the net,\u201d said Bai. Instead, Bai views the system like Stenglein \u2013 \u201cdysfunctional\u201d.<\/p>\n

\u201cWe have toxic soil \u2013 that\u2019s why we\u2019re seeing all kinds of outlandish plants grown.\u201d<\/p>\n","protected":false},"excerpt":{"rendered":"Medical debt financing and \u201cpatient access\u201d companies are pitching their services to struggling rural hospitals nervous about keeping…\n","protected":false},"author":2,"featured_media":179187,"comment_status":"","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[4316],"tags":[105,4348,16,15],"class_list":{"0":"post-179186","1":"post","2":"type-post","3":"status-publish","4":"format-standard","5":"has-post-thumbnail","7":"category-healthcare","8":"tag-health","9":"tag-healthcare","10":"tag-uk","11":"tag-united-kingdom"},"share_on_mastodon":{"url":"https:\/\/pubeurope.com\/@uk\/114672147172645420","error":""},"_links":{"self":[{"href":"https:\/\/www.europesays.com\/uk\/wp-json\/wp\/v2\/posts\/179186","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.europesays.com\/uk\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.europesays.com\/uk\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.europesays.com\/uk\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/www.europesays.com\/uk\/wp-json\/wp\/v2\/comments?post=179186"}],"version-history":[{"count":0,"href":"https:\/\/www.europesays.com\/uk\/wp-json\/wp\/v2\/posts\/179186\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.europesays.com\/uk\/wp-json\/wp\/v2\/media\/179187"}],"wp:attachment":[{"href":"https:\/\/www.europesays.com\/uk\/wp-json\/wp\/v2\/media?parent=179186"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.europesays.com\/uk\/wp-json\/wp\/v2\/categories?post=179186"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.europesays.com\/uk\/wp-json\/wp\/v2\/tags?post=179186"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}