The proportion of U.S. physicians providing free or reduced cost care dropped 8% in the last decade, from 76% of physicians in 1996-97 to 68% of physicians in 2004-05, according to a national study released today by the Center for Studying Health System Change. In 2000-01, 71.5% of physicians provided such care. While the proportion of physicians providing charity care has declined, the number of physicians offering charity care has remained relatively stable because the overall number of U.S. practicing physicians increased in the last decade. The amount of physician charity care relative to the number of uninsured has dropped, with the number of charity care hours per 100 uninsured people falling from 7.7 hours in 1996-97 to 6.3 in 2004-05--an 18 percent decline. Most of this decrease has occurred since 2000-01, primarily because of the large increases in the uninsured, from 39.6 million in 2000 to 45.5 million in 2004.
"This study provides additional evidence of the serious breakdown of the system of cost shifting that for years supported charity care," said Richard L. Clarke, DHA, FHFMA, president and CEO of HFMA. "With government and private payers increasingly unwilling to pay the 'hidden tax' for charity care, the ability and willingness of physicians and hospitals to provide this care is more limited. This study further demonstrates the critical need for this country to address the problem of covering the uninsured. Only a focused effort, similar to the Bush Administration’s approach to universal adoption of the electronic health record, will solve this problem."
William F. Jessee, MD, FACMPE, president and CEO, Medical Group Management Association, commented, "There are probably a variety of reasons why this trend is emerging, but one of the principal ones is likely the rapidly deteriorating economics of medical practice.... The truth is that it's a bothersome change--but we don't really understand all the reasons why it's occurring."
Edward Hill, M.D., president of the American Medical Association, told HFMA, "Physicians are committed to providing charity care and nearly 70 percent of physicians provide uncompensated care worth more than $2,000 every week."
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