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4.4.7 Total Hospital Charity Care and Charity Care as a Share of Total Patient Service Revenue
Why is this important?
According to Washington State law, charity care refers to “necessary hospital health care rendered to indigent individuals, to the extent that they are unable to pay for the care, the deductibles, or the co-insurance amounts that are required by a third-party payer.” A person is considered indigent if their household income is at or below 200% of the federal poverty level. Washington State legislation adopted in 1989 (RCW 70.170.060) prohibits hospitals from denying access to emergency care based on inability to pay and prohibits hospitals from developing admission policies that may significantly reduce charity care.
Charity care is reported as billed charges that have been written off. Charity care is distinct from bad debt, which consists of those fees which a hospital writes off due to their inability to collect from patients whose care has not been classified as charity care. Bad debt excludes contractual adjustments. The share of adjusted hospital revenue taken by charity care and bad debt is one way to measure a hospital's contribution to the community, although it does not tell the whole story. Charity care falls into the general category of “community benefit” provided by hospitals while bad debt does not. The provision of a certain level of community benefit is essential for non-profit hospitals to retain that tax status. Finally, monitoring this trend can help identify healthcare access needs.
This indicator measures the amount of charity care and bad debt incurred by hospitals in Walla Walla County. It is also presented as a percent of the total adjusted revenue of hospitals in Walla Walla County. Adjusted revenue is calculated by taking the total revenue and then subtracting all Medicare and Medicaid charges. State-owned psychiatric hospitals, federal Veterans Affairs hospitals, and federal military hospitals are not counted in this indicator. Washington State is offered as a benchmark. Additional information, including the total charity care, bad debt, and adjusted revenue totals for each individual hospital in the county, can be found in the “Download Data” section.
Where are we?
During 2022 in Walla Walla County, the total hospital charity care was $14.6 million, increasing from $5.1 million, since 2007.
During 2022, the hospital charity care as a share of net hospital revenue in:
- Walla Walla County was 2.1%, decreasing from 2.4% in 2007.
- Washington State was 1.3%, decreasing from 2.2% in 2007.
Data Sources
Washington State Department of Health: Comprehensive Hospital Abstract Reporting System (CHARS)
- Select the Excel file link labeled "Summary of charity care amounts provided by hospitals in Washington, 2021-2007 (Excel)."
- Select the Excel sheet with the desired year and scroll down to the Eastern Washington Region.
- Locate desired hospital, then look under the columns labeled"Total Patient Service Revenue," "Charity Care," and "Charity Care as a % of Total Patient Service Revenue."
- For the Washington State total, scroll to the bottom of the spreadsheet and locate the totals under the same columns as the county hospital data.
