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Study Finds Physician Charity Care Declining

MARCH 23, 2006 -- Ongoing financial pressures and changes in physician practice arrangements have contributed to a decline over the last decade in the proportion of physicians providing charity care, a new study has found.

The report, released Thursday by the nonpartisan Center for Studying Health System Change (CHSC), found that while about three-quarters of physicians provided free or reduced cost care 10 years ago, that figure has now declined to about two-thirds. The drop occurred as the number of uninsured Americans grew to 45.5 million in 2004, creating growing stress on the health care safety net.

"Already, there are signs that uninsured Americans are having more problems getting care, and if the decline in physician charity care continues, those problems are probably going to get worse," CHSC senior researcher Peter J. Cunningham said in a news release.

The study also found, however, that the actual number of physicians offering charity care has remained relatively stable because the overall number of U.S. practicing physicians increased from about 347,000 in 1996–97 to 397,000 in 2004–05, the group said.

Other findings of the report include:

  • The proportion of physicians providing charity care declined across all major specialty groups and geographic regions and in both urban and rural areas. Surgeons are most likely to provide charity care because they encounter many uninsured patients in hospital emergency rooms.
  • Levels of charity care are highest among physicians in solo or small group practices and those that are full or part owners of their own practice. Physicians in larger groups or institutional-based practices, such as medical schools or hospitals, are less likely to provide charity care.
  • Physicians at the highest income levels—$250,000 or greater —provide more charity care than physicians who make $120,000 or less.

American Medical Association President J. Edward Hill said that nearly 70 percent of physicians provide uncompensated care worth more than $2,000 every week despite increasing time and financial pressures.

But another solution must be found, Hill said. "Charity care is not the solution for the 46 million Americans who are uninsured," he said.

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