COHC logo
About Us Members Resource Center Media/Publications Issues/Advocacy

Indigent Care 

Serving the Indigent: A Unique Approach

In Franklin County, all residents—regardless of their ability to pay—receive the same quality of care at the community’s acute-care hospitals. Unlike other communities, which have passed a special tax for care of the indigent or established separate, public charity hospitals, central Ohio has a long-standing “equal access” healthcare system.  The ability of central Ohio hospitals to sustain this system is in part due to their unique agreement to follow the same inclusive guidelines when providing free and significantly discounted care to the indigent. Franklin County hospitals provide free, medically necessary hospital care to all residents with family incomes under 200 percent of the federal poverty level (FPL), or $47,700 for a family of four. Hospitals also provide significant, individually determined discounts on medically necessary hospital care for patients with family incomes up to 400 percent of FPL, or $95,400 for a family of four.

Hospitals' Community Benefit: Serving Those in Need

In fiscal year 2009, Franklin County’s four not-for-profit health systems provided $462 million in care and services for which they were not reimbursed, a 16 percent increase over 2008 levels. To meet their charitable missions and provide benefit to Central Ohioans, our health systems:

  • Contributed nearly $172 million to numerous programs, services and activities that improve the health of our citizens, for which they were not reimbursed. These activities include health improvement programs, subsidized clinical programs that operate at a loss, health professions education and medical research.

  • Provided more than $189 million in free care for people without insurance or who are unable to pay their hospital bills. Over the last six years, hospitals’ free care to the uninsured has increased by a staggering 183 percent.

  • Provided more than $174 million in free care to Medicaid patients—a 57 percent increase over 2008 levels. Known as Medicaid shortfall, hospitals routinely fill the gap left when government payments fall below hospitals’ cost to provide services. Over the past five years, Medicaid reimbursement to hospitals has declined. In 2004, state government has reimbursed hospitals 95 percent of the cost of caring for Medicaid patients; by 2009, hospitals were receiving 82 percent of their costs.



In 2011, The Central Ohio Hospital Council released the "Our Contributions to the Community" report to highlight the many ways Franklin County hospitals support the community, To enhance the report, the CEOs of the four hospital systems have filmed video commentaries on the four topics highlighted in the report:
  • Hospitals' Community Benefit, discussed by Claus Von Zychlin, president and CEO of Mount Carmel Health System;
  • Hospitals' Economic Contributions, discussed by Dave Blom, president and CEO of OhioHealth;
  • Hospitals' Quality Collaborations, discussed by Dr. Steve Allen, CEO of Nationwide Children's Hospital;
  • Hospitals' Unique Efforts to Serve the Indigent, discussed by Dr. Steve Gabbe, CEO of The OSU Wexner Medical Center

Read the report and view the video commentaries at our "Our Contributions to the Community" page. 

Working with Patients in Need of Financial Assistance

Central Ohio hospitals share a set of common principles when it comes working with patients who may need assistance in paying their hospital bills:

  • Fear of a hospital bill should not deter anyone from seeking medically necessary care in a Franklin County hospital.

  • All patients will be treated with dignity, compassion and respect and in a culturally appropriate manner.

  • All patients will receive the same high quality of care regardless of their race, religion, sex, national origin, disability, familial status or ability to pay for health care services.

Hospital leaders have agreed to principles which each hospital system follows when working with patients in need of financial assistance.

Contact Us

© Central Ohio Hospital Council
155 East Broad Street
23rd floor
Columbus, OH 43215-3609
(614) 358-2710