Despite refusing MLK50: Justice Through Journalism’s requests for an in-person interview to discuss Methodist Le Bonheur Healthcare’s relentless courtroom pursuit of unpaid medical debts from poor patients, CEO Michael Ugwueke offered a response, of sorts, online in Sunday’s Commercial Appeal.

Ugwueke’s response came after MLK50 and ProPublica revealed the hospital filed more than 8,300 lawsuits over a five-year period for hospital bills many defendants simply can’t pay. Many of the defendants are low-wage, and some of those low-wage workers are Methodist’s own employees. Large amounts of interest and attorney’s fees can balloon the costs, making payoff a near impossibility. Figuring in the average life expectancy for black Americans (and most of these defendants in court are black), some defendants will be paying for the rest of their lives.

Ugwueke did say that the hospital will review its policies over the next 30 days, and we’ll be watching and waiting.

Still, much like the written responses the system provided days before our Profiting From The Poor series debuted on June 27, Ugwueke’s defense of the hospital’s debt collection practices missed the mark. Here’s how.

1. What Methodist CEO Michael Ugwueke said …

“Nobody cares for more people in Shelby County than Methodist. Every person matters to us.”

Maybe so, but …

This is what is called a “red herring,” a distracting statement that does not speak to the facts. And the facts show the hospital won a higher percentage of wage garnishments than its nonprofit peers in Memphis. That plus the hospital’s stingy financial assistance policy makes it an outlier.

2. What he said …

“The spotlight placed on our health system does not accurately portray our team members or the extensive and thoughtful processes we have in place to help both uninsured and insured patients.”

However …

This investigation is about business practices, not patient care. Plus, the point is to show the effect of relentlessly pursuing collections against insured patients, some of whom do not earn a living wage and may work for the hospital system in low-wage jobs. This series was written to point out systemic issues that can be addressed, as illustrated by other nonprofit hospitals inside and outside of Memphis that don’t pursue legal action to collect on unpaid bills.

The place for positive publicity is the hospital’s careers page, which lists awards the hospital has won of late.

3. What he said …

“Each year Methodist provides over $220 million in community benefit services and contributions to care for the most vulnerable among us. This total includes charity care — care that is offered for free or at a greatly reduced cost — that is provided to patients who do not have the ability to pay.”

But …

Under the IRS rules, nonprofit hospitals can include as “community benefit” health education programs, workforce development and cash and in-kind contributions. In fact, on the hospital’s 2017 tax filing, it notes under in-kind contributions the hours that hospital employees spent serving on community organization boards such as the Overton Park Conservancy and the Tennessee Business Roundtable.

And what about those patients so mired in medical debt and out-of-control interest? Surely these individuals, such Carrie Barrett, don’t feel like they are a statistical anomaly. The Barretts of the world are striving, working human beings who deserve dignity and relief from an institution charged by its Christian affiliation and a federal mandate to do so. This large but vague reference to community benefit doesn’t explain this. A face-to-face interview to drill down on this would be illuminating.

4. What he said …

“Our team will work with every patient — insured and uninsured — struggling with medical expenses.”

But …

First, the series focused on insured patients who can’t pay. But how can any of these patients access this help if financial assistance policies are not publicly posted? And yes, we see the signs are appearing now, just as this series debuted. But what about before then? What about the thousands of patients sued in the last five years — did they know relief was possible? And if you “will work with every patient,” what is the process? How will patients know what that process is?

5. What he said …

“In every case, the only time we pursue legal action to collect a debt is when the patients who can pay refuse to work with us.”

Yet …

Patients-turned-defendants say that’s not true. Several told a reporter that they never received a bill from Methodist. Others said that they tried to work out a payment plan with the hospital’s collection agency, Revenue Assurance Professionals, but the agency refused to accept the monthly payment they offered.

6. What he said …

“… we only went to court to collect debt from uninsured patients for less than one tenth of one percent of all the uninsured patients we saw.”

But …

Again, the series is focused on low-income insured patients. Insured. Again, these are human beings, not numerical anomalies. The fallout of being dragged into court can ruin a patient’s financial health for a lifetime. That’s certainly true in Carrie Barrett’s case.

7. What he said …

“Consider this, Methodist is the only system with hospitals in all four quadrants of our community.”

We know and also …

Our story said that. “Methodist says it has ‘a hospital in all four quadrants of the greater Memphis area, unparalleled by any other healthcare provider in our region,’ plus more than 150 outpatient centers, clinics and physician practices.”

But also, what about embodying the true spirit of community benefit by freeing the poorest residents from the crushing vise of never-ending medical debt? This statement is a distraction otherwise.

8. What he said …

“Over the next 30 days we will be reviewing our policies and procedures to ensure we are doing everything possible to provide every Memphian with the care and assistance they need.”

Please note that …

Change is possible.

On June 26, the day after the American Medical Association released a study about similar tactics at Mary Washington Healthcare in Virginia, the hospital announced it was halting the practice of suing patients.

“We have decided it is in our community’s best interest to suspend the practice of pursuing legal action for unpaid bills,” the hospital said on its website.

A senior executive at Mary Washington Healthcare told the Free Lance-Star newspaper in Fredericksburg, Virginia, that cases now in the system will be put on hold pending an evaluation expected to last six months.

The St. Joseph, Missouri, Heartland Regional Medical Center, now Mosaic Life Care, changed its financial assistance policy following a ProPublica investigation that revealed the nonprofit hospital was quietly suing thousands of low-income patients. Mosaic instituted a medical grace period, NPR reported, and 3,342 people got a total of $17 million in debt relief.

Sen. Chuck Grassley (R-IA) made inquiries, saying “Let me be clear: Nonprofit hospitals should not be in the business of aggressively suing their patients,” he said. “In essence, because of the favorable tax treatment these hospitals receive, they have a duty to help our nation’s most vulnerable.”

9. What he said …

“We want all patients to know and understand our financial assistance policies and we want to ensure our policies reflect our mission.”

Agreed …

We do, too. That’s why we pointed out the fallacy in having policies that are not publicly posted, and illustrated what can happen when living up to that mission — serving “in a manner which supports the health ministries and Social Principles of The United Methodist Church to benefit the communities we serve” — falls short.

We’re interested in hearing from people who know more about Methodist Le Bonheur or other hospitals or doctors’ offices in Memphis. Talk to us if:

  • You’ve been sued by a hospital or doctor
  • You have medical debt that’s been difficult to pay off
  • You work for a hospital or collection agency and have something to share about their financial practices

Send us an email: memphis@propublica.org.

Leave us a voice message or text us: 347–244–2134.

Have you been sued by a hospital, doctor, or other Memphis institution? Tell us about it.

Follow the Profiting from the Poor series here.

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