6

From a customer standpoint in the US, does it make any financial difference to go to a non-profit hospital or a for-profit hospital?

9
  • And how would we know what choices you have? We can't know what hospitals you're considering, what's your insurance coverage, what the procedures are - these are all relevant considerations in choosing a medical provider. Whether or not the provider takes profits home or not may not at all be directly relevant.
    – littleadv
    Feb 25, 2022 at 18:58
  • 1
    @littleadv I don't care about average Joe. I'm not interested in a specific hospitals/procedure, I'm looking for a general answer. You could rephrase the question as "is the fact that a provider takes profits home the financially relevant to the customer, and if so, how?" Feb 25, 2022 at 19:01
  • 5
    @littleadv I don't think this question is ridiculous at all. I think this is a reasonable question to have, which deserves a reasonable answer. In fact, from a bit of searching I think that financial assistance programs might be required for non-profit hospitals, but I don't know enough to write a full answer, and am interested to see if anyone else does!
    – Numeri
    Feb 25, 2022 at 19:21
  • 1
    @Numeri The question got closed so I guess we will never know. Feb 26, 2022 at 21:18
  • 1
    @FranckDernoncourt I have no idea how a yes or no question could be opinion based, and I'm sad to see that no one else knew more about the Affordable Care Act financial assistance programs than my quick google
    – Numeri
    Feb 27, 2022 at 0:16

1 Answer 1

11

I wonder the following: from a customer standpoint, does it make any financial difference to go to a non-profit hospital or a for-profit hospital?

The number one concern is "is the hospital in-network or out-of-network?"

In-network means that the rates you will be charged will be at the negotiated rates. It also means that anything you have to pay applies to your in-network deductible. The hospital will also bill your insurance company.

If the hospital is out-of-network you will generally pay higher rates. The money you pay will be applied against the generally higher and separate out-of-network deductible. Also they will only credit the amount of the negotiated rate, everything above that is not the insurance companies concern. The hospital won't file the claim for you. In a typical hospital stay there are multiple bills: from the ER, from the surgeon, from the anesthesiologist, from the lab, from the pharmacy...

If you go in-network, the profit status of the hospital makes no difference. All the rates will be the same.

9
  • 7
    Actually this can be even worse than this... In one hospital you can have "in-network" and "out-of-network" doctors, so be careful in selecting a doctor and then the anesthesiologist is out of network. Health insurance in the US is disgustingly complicated.
    – Ron Beyer
    Feb 25, 2022 at 16:27
  • 4
    @RonBeyer some states have prevented that situation, and I believe the federal government is also working on that. Feb 25, 2022 at 16:42
  • 1
    @RonBeyer I've also seen a transfer from one "in-network" hospital to another via a $2000 "out-of-network" ambulance. It's all bad.
    – eclipz905
    Feb 25, 2022 at 18:01
  • 1
    Thanks. If I go out-of-network, does the profit status of the hospital make any difference? Feb 25, 2022 at 18:53
  • 1
    @eclipz905 ushealthgroup.com/2021/04/14/… "Can a Facility Be In-Network but Have Out-of-Network Staff? The answer is yes – especially in the case of hospitals and clinic settings." Indeed it's all bad. Feb 25, 2022 at 18:55

Not the answer you're looking for? Browse other questions tagged .