Atrium Health, a major healthcare provider in North Carolina, finds itself under intense scrutiny in 2023 due to its billing and collections practices. The state’s treasurer published a revealing report highlighting that “litigious” hospitals in North Carolina, including Atrium Health, filed over 7,500 lawsuits in a span of five years. This development has brought to the forefront issues of inflated reimbursements and aggressive legal tactics against patients, raising questions about the provider’s role in the growing medical debt crisis.
The report's findings indicate that Atrium Health inflated reimbursements for tests by approximately 400%, upgrading "moderate complexity" tests to "high complexity" to secure higher payments. In a related legal battle, over 90 physicians from the Charlotte area sued Atrium Health in April 2023. They accused the system of employing "illegal" tactics to suppress competition for medical care. Meanwhile, Atrium Health maintains that it resorts to debt collection services only when accounts are over 120 days old and does not report uncollectable accounts to credit agencies.
From 2008 to 2022, Atrium Health's hospitals pursued legal action against more than 4,400 patients, seeking claims amounting to at least $74 million. The judgments reviewed ranged from as little as $301 to as much as $783,000. Notably, in 2010, Atrium Health secured a $7,497 judgment against a patient and her home, followed by a $5,771 judgment against another patient in 2013. The practice of filing lawsuits against its own patients dates back to as early as 2004.
Advocate Health, Atrium Health's parent company, contends that the lawsuit lacks merit. An Advocate Health spokesperson stated:
“This lawsuit has no merit, and we categorically reject these baseless claims.”
Despite their defense, Atrium Health’s historical financial practices remain contentious. In 2017, Carolinas Healthcare, now known as Atrium Health, paid $6.5 million to resolve allegations of defrauding the U.S. government by overcharging Medicare and Medicaid for urine drug tests.
In response to mounting criticism, Atrium Health has expanded its charity care program. It now includes individuals earning up to 300% of the federal poverty level, translating to roughly $77,000 annually for a household of three. Furthermore, in March 2024, Advocate Health ceased the practice of using South Carolina’s department of revenue to garnish state income tax refunds from patients.
Advocate Health acknowledges the challenges within the healthcare system. An Advocate Health representative expressed:
“We recognize that no large organization is perfect or without a need to improve. We also recognize the weight a person can feel when trying to manage the cost and complexity of America’s healthcare system.”
The organization emphasized its commitment to easing the repayment process through third-party services like AccessOne:
“Using AccessOne provides choice for our patients while taking some of the administrative burden off of our teams during the repayment period.”
Brad Clark, Advocate Health's chief financial officer, highlighted efforts to address medical debt issues:
“We believe our financial assistance program is now among the most generous in the nation and Advocate Health is committed to being part of the solution to address the medical debt dilemma so many people are facing today.”
Eugene Woods, CEO of Atrium Health, underscored the importance of equitable healthcare access:
“Your zip code and color of your skin should not have a high correlation coefficient to your health.”
Woods further articulated his vision for expansion and improved service delivery:
“Size will enable us to serve our communities.”
“We’re just looking to do that more, better, faster.”
Vice-President Kamala Harris also weighed in on the broader implications of medical debt:
“No one should be denied economic opportunity because they got sick or experienced a medical emergency.”