UK-based newspaper The Guardian has published an extensive article about Advocate Health (owner of Atrium Health and other hospital systems). Advocate is now one of the largest health care systems in the country, the result of multiple mergers and acquisitions. Atrium has had a number of embarrasing stories published about their aggressive collection tactics; in 2023 they ceased selling off debt to third party collectors – or debt abolishment organizations such as Undue Medical Debt. When Governor Cooper announced his plan last summer to encourage hospitals to forgive unpayable medical debts — mostly owed by people who would have had Medicare had it been expanded – Atrium and its parent fought the plan vigorously, only agreeing at the last moment. However, after agreeing, Advocate/Atrium set about a media campaign to gain good PR about how they were generously forgiving debts and removing liens placed on homes during their aggressive collection efforts. An exposé by NBC profiled an example of an older lien, which embarassed the hospital chain into removing some liens that fell outside the Governor’s program. NBC later followed up on the expanded forgiveness program. In many cases, debtors had made regular payments but ballooning interest debt meant that after many years of payments, they still owed almost the same – or more – than was originally financed.
However, extensive concerns remain about Advocate/Atrium’s billing and collection practices. The focus of the organization, mostly led by financiers and insurance executives, seems to be maximizing cash flow and constant expansion. Critics say that the bureaucracy is top-heavy and overpaid, resulting in high costs for medical treatment. Former NC State Treasurer Dale Folwell published a report in 2021 that Atrium’s spending on charity care equaled less than 60% of the value of the tax breaks it received as a non-profit. Advocate/Atrium and the Charlotte-Mecklenburg Hospital Authority are governed by state statutes from 1943, which never envisioned the corporatization that is occurring today.
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Photo of Atrium Health hospital in Charlotte, North Carolina by Jesse Barber/The Guardian
