Thread by @Farzad_MD

1/ Medical Debt- a holiday story

A few years ago, I found myself poring over a printout of ED frequent fliers with a PCP in Mississippi.

The office manager knew why they were going to the ED.

“They’re not going to show their faces here. They all owe us money.”

2/ Because of the Emergency Medical Treatment & Labor Act, the ED would see them even if they owed money

But thousands more dollars would have been added on top of the prior debts

His bills will climb. His credit score will drop. Collection agencies will start hounding him

3/ When I was in college I got dehydrated at a crew meet and an ambulance took me to the ER. A couple of liters of fluid later I was fine

But I couldn't figure out what to do when the bills started coming

For years I carried the stress and shame of being sent to debt collection

4/ I was lucky.

This is what 100 million Americans with medical debt have sacrificed

It's a complete and utter indictment of the financial structures in our health care system

#DiagnosisDebt lays it out in a chilling series of articles from @npr @KHNews @NoamLevey

5/ Four in every ten American adults say that they’ve delayed medically necessary care because of it

It’s a leading cause of bankruptcy.

Black Americans face more aggressive debt collection and higher rates of medical defaults

This is what “Social Determinant of Health” means

6/ The root causes are a gruesome dissection of our HC financing system:

lack of access to primary care
un/under-insurance
generational poverty/structural racism
surprise medical billing
cost-shifting to “consumers"
hospital consolidation

@MarkMiller_DC

https://twitter.com/MarkMiller_DC/status/1605724972382445568?s=20&t=C0GRAFu_aWmufAbo6aSvbw

7/ Our action today isn’t attacking these upstream causes, but we’re going to try to ameliorate the pain

In partnership with @RIPMedicalDebt we @AledadeACO are abolishing the debt of more than 85,000 patients in MS & LA- the states with the worst health outcomes in the country

8/ The economics are astounding. @RIPMedicalDebt founded by former debt collectors has figured out how to purchase and abolish $100 of debt for about $1

This will cost us only a few hundred thousand dollars in donations – matched by RIP (thx to philanthropist @mackenziescott)

9/ Over 80,000 patients are going to get a letter than looks something like this

10/ It has particular resonance for me that we are doing this in Mississippi and Louisiana.

We've had the honor of working with some amazing practices and health centers in these states. They are doing heroic work, and they can use every bit of help.

resources.aledade.com/blogs/5-secret…

11/ I recognize that this isn't going to help many of the patients we saw on the list that day.

The debt we are retiring has already wrought many years of toxic harm, and tends to be what could readily be purchased from health systems

We can do even better I think

12/ We are actively working with @RIPMedicalDebt to aggregate and eliminate medical debt for qualifying patients who are seen in community primary care practices

We will be going upstream

Each patient with their debt retired will be a patient who can reconnect with their PCP

13/ I hope that we can join forces with @aafp @MGMA @CMAdocs and others to reach out to community practices- particularly those in value-based care- to purchase and wipe out the debt held by them, and remove any barrier for their patients to return to them instead of the ED

14/ Their patients won’t have to be ashamed to go back to their clinics. They can get a wellness visit, or ask a doctor about a recurring pain they’ve had-- without waiting until it’s become so severe or complicated that an ER visit is their only option.

They can reconnect

15/ I'm proud to work at @AledadeACO where our values and mission are aligned with what's good for patients, good for doctors, and good for society.

I will never take that for granted.

16/ If you or someone you know is struggling with medical debt, there are resources that might be able to help.

(A former colleague literally reached out yesterday looking for help)

The Consumer Financial Protection Bureau is one place to start

consumerfinance.gov/ask-cfpb/is-th…

❤️🙏

17/ I strongly encourage you to help others by learning about and donating to @RIPMedicalDebt this holiday season

they are the real deal

read about them here:

npr.org/sections/healt…