Hospitals with the highest total uncompensated care costs

Which hospitals have the highest uncompensated care costs? 

NYC Health and Hospitals - Bellevue has the highest total uncompensated care costs among U.S. hospitals with $1,065,702. This facility is the oldest hospital in the U.S. and has an academic affiliation with the New York University School of Medicine. It is also the flagship facility for the NY Health and Hospitals health system, which operates across all five boroughs.  

Coming in second place for hospitals with the highest uncompensated care costs is NYC Health and Hospitals - Elmhurst with total uncompensated care costs reaching $769,601,333. Another member of the NYC Health and Hospitals health system, this facility is the second oldest in New York City and serves as the primary hospital for over 1 million residents in Queens, one of the most ethnically and linguistically diverse communities in the United States. 

Rounding out the top three is Ben Taub Hospital with $765,193,085. Located in Houston, Texas, this level I trauma center is owned and operated by the Harris Health System and is staffed by the faculty, residents, and students from Baylor College of Medicine.   

Eleven of the top 20 hospitals by total uncompensated care costs are in New York, with eight in New York City alone. In addition, four are in Texas, and two are in Florida. These hospitals represent large metropolitan medical centers that serve large communities of people. Many of these facilities are located in lower income but highly populated areas where patients are more likely to be uninsured or unable to afford care. As a result, uncompensated care rates at these facilities remain much higher than in other parts of the country. 

How is uncompensated care calculated? 

Uncompensated care costs are calculated on a hospital-by-hospital basis. 

First, the total uncompensated care charges are calculated by adding the hospital’s bad debts and its total charity care charges together. That number is then multiplied by the hospital’s cost-to-charge ratio, or the ratio of total expenses to gross patient and other operating revenue. The hospital’s uncompensated care costs are the resulting integer from this equation.  

What are the effects of uncompensated care? 

Every hospital will take on at least some portion of uncompensated care, but some facilities can afford to take on more of this debt than others.  

Hospitals and other care facilities are not viable if they leave gaps in payment and must allocate funds to cover hospital bad debt and charity care costs. When this happens, the facility is left with less money to pay physicians and staff, obtain essential medical supplies, and provide other health and wellness initiatives. As a result, the overall quality of care at that facility will start to decline.  

Minimizing gaps in payment and bad debt is essential for a hospital to remain financially stable.  

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