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Hospitals In Action

Missouri Hospitals Provide Record $1.8 Billion In Uncompensated Care And $3.5 Billion In Total Community Benefit

Missouri hospitals are always essential.

While COVID-19 impacted almost every aspect of health care, one thing remained unchanged — hospitals’ commitment to their patients and their communities.

Despite the unprecedented challenges faced in 2020, Missouri hospitals provided more than $1.8 billion in uncompensated care and $3.5 billion in total community benefit.

With the sudden onset of COVID-19, Missouri hospitals were forced to quickly — and continuously — adapt as they learned how to navigate the pandemic. In addition to treating COVID-19 patients, hospitals worked diligently to keep their communities safe by implementing screening measures for patients and visitors, establishing drive-through testing sites, expanding telemedicine capabilities, and reallocating their staff to best serve patients.

In 2020, Missouri hospitals provided more than $1 billion in charity care. Charity care is the amount of care provided by hospitals at no cost to individuals who don’t have insurance and/or the ability to pay. Hospitals also incur bad debt. This occurs when patients have unpaid out-of-pocket costs or fail to make agreed-upon payments for care. In 2020, hospitals’ statewide bad debt costs were more than $721 million.

The combination of charity care and bad debt equals more than $1.8 billion in total uncompensated care provided by Missouri hospitals in 2020. When these costs are added to other community-supporting expenses, that equals hospitals’ statewide community benefit. In the same year, Missouri hospitals provided more than $3.5 billion in total community benefit — an increase of nearly $100 million from 2019, and a 16% increase throughout the last decade.

Even throughout the pandemic surges, hospitals continued to provide lifesaving care unrelated to COVID-19. Missourians still broke bones, gave birth, received chemotherapy and needed surgery. Hospitals’ operating revenue decreased in 2020; however, federal relief helped reduce the losses overall. Nonetheless, the commitment to providing a safety net for care was strong — for every $1 in net income, hospitals provided $2.13 in uncompensated care in 2020, an increase from $1.54 in 2019.

Missouri hospitals strengthen their communities.

Missouri hospitals’ investments in people and infrastructure continue to power local economies.

None of the benefit provided by Missouri hospitals would be possible without a strong workforce. In 2020, Missouri hospitals employed more than 170,000 individuals — a 42% increase throughout a decade — at a payroll and benefit cost of $12 billion. All hospital staff — from nurses to housekeepers, respiratory therapists to cafeteria workers — supported efforts to combat COVID-19 in their communities, and their salaries ripple throughout the community.

Hospitals also invested $1.6 billion in infrastructure and equipment in 2020 — an increase of more than $400 million throughout a decade. Capital investments support local economies by supporting additional employment and economic activity in the communities hospitals serve.

Impact of Federal Relief Funds

Many hospitals received COVID-19 relief payments from the federal government. Despite the benefit provided by these programs, a significant number of Missouri hospitals are operating with negative margins.

Hospitals and COVID-19

Missouri hospitals always will be essential to their communities and will serve a vital role in maintaining and improving health. Hospitals are there for Missourians in times of crisis — whether it’s serving their communities throughout a pandemic, providing a safety net for those without health insurance or caring for those in a time of need. COVID-19 likely will impact health care long term. While some of those impacts remain to be seen, one thing is certain: Strong communities need strong hospitals, throughout the pandemic and beyond.

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