New Report Finds Nonprofit Hospitals’ Billing Practices Burden Patients Despite Significant Tax Benefits Says

01.16.2026 /Press Release

A second analysis details widespread profiteering at top hospital corporations

WASHINGTON, D.C. - A new report * released by Families USA, examines how many nonprofit hospitals continue to bill and pursue debt from patients who likely qualified for financial assistance, despite receiving substantial tax benefits intended to support affordable care in their communities. Drawing on findings from federal agencies, state investigations, and academic research, the report documents persistent gaps between the tax advantages nonprofit hospitals receive and the charity care or financial assistance patients actually obtain.

"Nonprofit hospitals receive significant public benefits, but far too often engage in egregious billing practices that harm under-resourced patients and communities," said Anthony Wright, Executive Director of Families USA. "While much of the attention has focused on corporate hospital profiteering, this report makes clear that serious accountability problems also exist in the nonprofit sector. At a time when health care costs across the system are too damn high, all hospitals must be held accountable for abusive billing practices."

Key Findings

• Eligible patients often do not receive financial assistance. Federal and independent analyses have identified at least $2.7 billion in bills sent to patients who likely qualified for charity care in just one year - an amount researchers believe understates the full scope.

• Hospitals continue to pursue debt from low-income patients. Investigations in states such as Washington and North Carolina found non-profit hospitals billing or suing thousands of patients who should have been screened for or granted charity care under their own policies.

• Tax benefits exceed community investment at many institutions. Recent studies, including a 2025 analysis of more than 1,800 non-profit hospitals, show that a majority receive more in federal, state, and local tax benefits than they spend on community investments - creating an estimated $11.5 billion annual gap.

• Federal oversight standards are poorly defined. The Government Accountability Office has found that community-benefit requirements lack clarity, contributing to inconsistent reporting and limited accountability around how hospitals earn or maintain tax-exempt status.

Families USA also released a separate report* highlighting how the nation's largest hospital corporations have prioritized profits and shareholder payouts over patient care as consumer costs continue to rise. Over the past five years, HCA Healthcare, Universal Health Services, and Encompass Health amassed a staggering $38.4 billion in profits while spending $32.5 billion on shareholder handouts. All three corporations have also faced significant federal penalties for allegations of fraud and misconduct.

"American families are paying more than ever for health care, while the largest hospital corporations are padding their profits and funneling billions to their Wall Street investors and top executives," said Wright. "Congress should treat these findings as a wake-up call and take action to end corporate greed and enact policies that will finally reign in the key drivers of this affordability crisis and actually lower health care costs."

The reports are released amid skyrocketing health care consolidation. A recent Kaiser Family Foundation (KFF) study warned that just one or two health systems now control nearly half of inpatient hospital care in almost half of U.S. metropolitan areas. At the same time a new Families USA poll shows that health care costs remain a top priority for voters nationwide.

*These reports were originally produced by Accountable.US and are being released by Families USA.