"I'd rather have cash today than wait two years for it, because I can make money on it," said Bruce Ritchie, vice president for finance at Peninsula Regional Medical Center.
Routine lawsuits
That philosophy is reflected in more than 16,000 collection lawsuits Peninsula has filed since the start of 2003, making it among the hospitals that sue most frequently, court records show.
Johns Hopkins Hospital, Maryland's largest hospital, and Johns Hopkins Bayview Medical Center have filed about 14,000 collections lawsuits between them over the past five years. In a written statement, the Hopkins system said it sues fewer than 1 percent of its patients and that it now sues less often than it did several years ago - although it acknowledged that it consistently refers about 20 percent of its patients to collection agencies. It said it sues only those patients who have the ability to pay.
Maryland hospitals have attached liens to the homes of more than 8,000 patients, court records show, despite American Hospital Association guidelines cautioning against wholesale use of the practice. That doesn't include homes in Baltimore City, where property liens are automatically entered in all civil judgments.
By contrast, several institutions are reluctant to take patients to court no matter how much they owe.
Bon Secours filed fewer than 400 collection cases from January 2003 through June 2008. Officials said their religious beliefs and desire for social justice keep lawsuits to a minimum.
Executives at Washington Adventist Hospital in Takoma Park said they sue patients as a "last resort" when they are certain the person has the means to pay the bill. The court data reflect that view. Adventist rarely sues, even though it lost $5.3 million last year on unpaid and charity care, the most of any Maryland hospital.
"We don't go out and start suing people. We know people are going through very stressful times. We don't want to cause a further burden on them," said William G. "Bill" Robertson, president and chief executive officer of Adventist HealthCare.
In 2006, the cost review board surveyed hospitals on their debt collection practices. The written responses showed that practices vary widely.
When asked under what circumstances it sues, Mercy Medical Center replied it does when a collection agency finds "monetary assets."
