• J Hosp Med · Feb 2025

    Medical debt in America, Part II: Financial support for the most vulnerable.

    • Blake N Shultz, Ahmed M Ahmed, and Luke Messac.
    • Brigham and Women's Hospital, Boston, Massachusetts, USA.
    • J Hosp Med. 2025 Feb 2.

    AbstractIn this second part of a series on medical debt and the costs of care, we examine the past and present financial protections for low-income patients at nonprofit hospitals. Born of almshouses and religious orders, nonprofit hospitals were devoted at their founding to the care of the poor. However, over the course of the twentieth century, they became more focused on high-priced care for paying patients. Federal regulations surrounding tax exemption and charity care have been loosened to allow hospitals to spend relatively little on financial assistance, contributing to inequitable and inadequate financial protections for low-income patients.© 2025 Society of Hospital Medicine.

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