December 19, 2013 — The number of Catholic hospitals increased by 16.1% between 2001 and 2011, and the Church's influence over those institutions is endangering women's access to reproductive health care, according to a new report from the American Civil Liberties Union and MergerWatch, Modern Healthcare reports.
The release of the report, called "Miscarriage of Medicine," coincides with a lawsuit ACLU filed last month against the U.S. Conference of Catholic Bishops on behalf of a Michigan woman named Tamesha Means. In the suit, ACLU alleges that a Catholic hospital failed to provide adequate care for Means, who came to the facility multiple times after her water broke at 18 weeks but was sent home (Kutscher, Modern Healthcare, 12/18).
At issue in the report and the lawsuit are the religious guidelines that direct health care at Catholic facilities. The Ethical and Religious Directives ban elective abortion, sterilization and contraception, and also restrict fertility treatments, genetic testing and end-of-life care. The rules can be interpreted to limit emergency care for women experiencing miscarriages or ectopic pregnancies, emergency contraception for sexual assault survivors, and the ability of health care staff to discuss treatment options or make referrals (Martin, ProPublica, 12/18).
Catholic Facilities Increase While Other Not-for-Profit Hospitals Decrease
The report found that there were 381 Catholic hospitals in the U.S. in 2011. Catholic hospitals accounted for 10.1% of all hospitals in the country in 2011, up from 8.2% in 2001 (Modern Healthcare, 12/18). Catholic hospitals now account for 10 of the 25 largest health systems in the nation.
Catholic hospitals grew as the number of other not-for-profit hospitals declined, the report found (ProPublica, 12/18). During the study period, the number of not-for-profit hospitals affiliated with other religions decreased by 41%, secular not-for-profit hospitals decreased by 12% and public hospitals decreased by 31%.
However, the report noted that hospital growth was strongest among investor-owned chains, which expanded their hospital holdings from 660 to 964, an increase of 46% (Modern Healthcare, 12/18).
In 2011, Catholic acute-care institutions accounted for one in nine hospital beds in the U.S., although the concentration of Catholic hospital beds varied in different parts of the country. Washington, Wisconsin and Iowa had high concentrations of Catholic hospital beds, the report found.
Findings on Public Insurance Programs, Charity Care
In addition, the report found that Catholic hospitals collected $115 billion in gross patient revenue through Medicare and Medicaid in 2011. The report called on the federal government to enforce laws protecting those patients (ProPublica, 12/18).
The report also found that charity care at Catholic hospitals accounted for 2.8% of revenue, a level just about even with the 2.9% of gross patient revenue that all hospitals reported as charity care (Modern Healthcare, 12/18). According to the report, charity care accounted for 2.9% of gross patient revenue at other religious not-for-profit hospitals and 5.6% at public hospitals.
MergerWatch Director Lois Uttley said the trend of Catholic hospitals expanding their reach through mergers and acquisitions "is continuing and perhaps even accelerating." According to the report, the largest Catholic health systems -- Ascension Health and Catholic Health Initiatives -- have grown an additional 30% since 2011.
Uttley said, "Ordinary people are not following hospital mergers and acquisitions," adding, "They don't know who runs their hospital, especially if it doesn't have a Catholic name" (ProPublica, 12/18).
The Catholic Health Association did not comment on the report, explaining that it had not finished reviewing it (Modern Healthcare, 12/18).