Analysis of 2,500 charity care policies finds patients with identical income and medical needs could receive free care at one hospital, yet face collections or lawsuits at another. More
Medical debt impacts tens of millions of Americans, contributing to financial harm and worse health. This report provides an overview of research on prevalence, impact, and drivers of medical debt, finishing with policy recommendations to address both the downstream problem of medical debt and the systemic issues behind the problem. Suggested citation: Past Due: How Medical Debt is Harming Americans and the Solutions We Need Now. Medical debt working group. Needham, MA: The Lown Institute, 2025. More
“We’re all here because this issue is a moral stain on the fabric of the country… We’re also here because if we want to fix this, we can," Dr. Vikas Saini told the crowd at the 2025 Lown conference on Medical Debt in America. More
Hospitals in 18 states own a total of $170 billion in assessed real property value and benefit from a total of $4.3 billion in real estate tax exemptions. However, this benefit is not spread out equally among states. More
The recently released study was conducted by the Boston-based Lown Institute, an independent healthcare think tank. The organization examined 1,800 nonprofit hospitals in 20 states, using average numbers from 2020, 2021 and 2022.
These 20 hospitals avoided nearly $1 billion in property taxes. More
What types of initiatives are hospitals investing in to improve access to care and community health? We dug into the tax forms for some of the largest fair share surplus hospitals to find out. More
Nonprofit hospitals in Colorado face renewed scrutiny over how much they spend locally compared to the tax breaks they receive. More
Outside the Meijer grocery store in Fairfax, Lachelle Dixon-Harris said the Clinic and other local hospitals need to help residents afford services — especially students and elderly residents. “They should have access to affordable health care that meets their needs — those who live in the community, not those who are coming from outside of the community, not those who fly in from other countries," she said. More
Nonprofit hospitals across Michigan received far more economic benefit from their tax-exempt status than they spent annually in community support and charity care over a three-year period. More
Garber also noted that nonprofit hospitals, specifically, are required to gather information about their communities’ most pressing health needs. Although the IRS Form 990 filed by nonprofit organizations includes Schedule H section requesting community-related spending, the section “includes a lot of information that has nothing to do with health care at all,” she said. “There’s definitely a need for transparency on what are you doing to address the health needs,” she said.
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Saini said there isn’t a clear pattern between which hospitals choose to give back and which don’t. In fact, they often coexist. “In any given city, you can often find two hospitals — one of which is in a surplus and one of which is in a deficit,” he clarified. “So it really seems that we have a tale of two hospitals in our health care.” More
New York’s nonprofit hospital sector receives tax breaks worth more than $2 billion each year, with the expectation that they’ll provide free services and invest in their communities. But dozens are falling short on community benefit spending, a new report shows. More
The annual calculations by the Lown Institute call into question whether the value a nonprofit community hospital gives to communities lives up to the taxes it doesn't have to pay. More
Two major Des Moines hospitals fell $70 million short on community support despite tax breaks, according to a report released Wednesday by the nonpartisan Lown Institute. Why it matters: The gap raises questions about whether tax breaks are doing their job — and whether vulnerable Iowans are paying the price. More
Mount Sinai Hospital ranks the fourth highest among hospitals across 20 states for spending far more money on charity care and helping its community than what it saves through tax exemptions, according to a new report from the Lown Institute. The West Side hospital spent an average of $78 million more a year on charity care and investing in its community than it saved from tax exemptions given to not-for-profit hospitals, between 2020 and 2022, according to the report from Lown, a Massachusetts-based think tank. More
Unlike other forms of debt, medical debt is extremely hard to avoid; nobody chooses to get sick, have an accident, or need emergency care. If you’re worried about medical debt, here are three ways you can help reduce your risk of debt. More
A recent investigation of the Mayo Clinic by the state AG found that the hospital put up barriers to financial assistance. More
On May 15, 2025, the Lown Institute will be hosting a one-day, in person conference in Washington, D.C. to discuss the scope, key drivers, and emerging solutions to medical debt in the U.S. Here's why you won't want to miss this event. More