Providence has fallen far since the Sisters of Providence incorporated in 1859 with the Washington territorial government for “the relief of needy and suffering humanity, in the care of orphans, invalids, the sick and poor. "
The decay of ethical leadership is endemic in the corporate world. It is all the more troublesome in health care systems, particularly those that are faith-based. Government regulators must continue to be vigilant, but what’s really needed is a more enlightened generation of business leaders who understand that cutting corners, cheating customers and flouting rules only lead to organizational rot and an eventual comeuppance.
Earlier this month, the state Attorney General’s Office announced an agreement with Renton-based Providence to resolve a lawsuit that alleged the health care giant trained its staff to aggressively ask for payment from patients with low incomes who were likely eligible for financial assistance or billed them without determining if they qualified. In thousands of cases, Providence knowingly sent low-income patients — including Medicaid enrollees — to debt collectors.
Providence must forgive more than $137 million in medical debt and refund more than $20 million to patients the company billed for services despite knowing they likely qualified for free or reduced-cost health care. The refunds and debt relief will help nearly 100,000 people.
In a statement, Providence said it “recognizes the tough challenges many members of our community face that result in them not completing the financial assistance application process and we are also making improvements to our processes to encourage more individuals to apply for such assistance, which we are happy to offer.”
The phrase “we are happy to offer” seems incongruent with information gleaned in the legal action. One of Providence’s own employees warned leadership that the health system’s practices were “sending the poor to bad debt.”
The gouging of patients with low incomes is all the more galling considering Providence CEO Rod Hochman is the state’s highest-paid health care executive, according to the Puget Sound Business Journal. Hochman received a total compensation package of $9.5 million in 2021, per the most recent data available for the system. In years prior, his pay reached nearly $11 million.
In a statement, Providence said it “recognizes the tough challenges many members of our community face that result in them not completing the financial assistance application process and we are also making improvements to our processes to encourage more individuals to apply for such assistance, which we are happy to offer.”
I swear to god, victim blaming shit like this should automatically double their fines.
The AG’s press release is an infuriating read.
[WA attorney general]Ferguson filed a lawsuit in February 2022, accusing Providence of billing and aggressively collecting money from low-income Washingtonians without determining if they qualified for financial assistance.
Ferguson’s Consumer Protection investigation started in 2020, following complaints about collection practices at Swedish. It revealed Providence engaged in numerous practices between 2018 and 2022 that prevented patients from accessing financial assistance. Providence trained employees on aggressive and deceptive collection tactics. Their script included:
- “Ask every patient every time” to pay outstanding medical costs;
- “Don’t accept the first no;”
- “If a patient declines the first request, ask for partial payment;”
- "Use phrasing that signals to patients “payment is expected.”
The lawsuit asserted that Providence knew many of its patients were likely eligible for financial assistance and not only failed to inform them, but also kept collecting payments from them. In fact, Providence sent thousands of patients it identified as “presumptively” qualified for financial assistance to debt collectors. Internal emails revealed Providence did this because it knew those patients were more likely to pay their bills if collection attempts continued.
Moreover, starting in 2019, Providence sent thousands of Medicaid patients to debt collectors. Medicaid enrollees are among the lowest income Washingtonians, and are deemed eligible for financial assistance under Providence’s own policies. Providence staff caught the issue early and raised concerns to leadership. In fact, according to internal records, one employee warned: “We are sending the poor to bad debt and not treating them the same as other patients.” Providence did not correct the problem for more than two years.
As expressions of God’s healing love, witnessed through the ministry of Jesus, we are steadfast in serving all, especially those who are poor and vulnerable.
Ah there it is! That explains it all.
