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Mary Shannon @marymshannon.bsky.social · 6d

For context: I'm not aware of any law "requiring" them to pursue medical debt in court, and while the targeting may not be intentional, the impact is clearly disproportionate in certain communities.

Mary Shannon @marymshannon.bsky.social · 6d

They did. When @stlpublicradio.bsky.social covered our research, WashU gave this statement. They emphasized their overall charity care & denied "targeting" anyone.

Screenshot from St. Louis Public Radio's coverage of the research, which includes a response from WashU. The text in the screenshot reads:

"WashU officials said those affected by the lawsuits represent a small sliver of the patients the medical group has treated. During the time period of the study, WashU Physicians treated nearly 1.5 million patients and provided $752 million in uncompensated care, “underscoring [Wash U’s] role as a critical safety net provider for the uninsured and underinsured,” said spokeswoman Julie Flory.

“In some cases, we are required to pursue collection of amounts owed by patients and only do so with people who have the means to pay, excluding, for example, those who are unemployed, work part-time, or are paying child support,” Flory continued. “We offer assistance to patients with financial needs. Any suggestion that we would target individuals from certain groups for debt collection is false and misguided, and anything that attempts to draw such a conclusion should be closely examined.”"

Spire gas rates will go up 10% this fall after Missouri regulators approve increase

Mary Shannon @marymshannon.bsky.social · Sep 4

For those keeping score at home:

🔥 Higher gas rates. Can't pay? Face a shutoff.

⚡ Higher electric rates. Can't pay? Face a shutoff.

💧 Higher water rates. Can't pay? Face a shutoff.

🛒 Higher grocery prices. Can't pay? Go hungry.

⚕️ Exorbitant medical costs. Can't pay? See you in court.

St. Louis Public Radio @stlpublicradio.bsky.social · Sep 3

Spire customers in St. Louis can expect their natural gas rates to rise by roughly 10 percent starting in October.

A ruling from the Missouri Public Service Commission will allow Spire to raise its monthly gas rates by 10% starting in October.

www.stlpr.org

Mary Shannon @marymshannon.bsky.social · Sep 3

Non-profit mission, tax-exempt status, and a $12B endowment. Yet WashU still takes patients to court over $104 medical debts and garnishes wages, even from their own employees. Make it make sense... 😵

Devin 🌞 Thomas O’Shea @devintoshea.bsky.social · Sep 2

Wash U has a staggeringly large endowment that could be put to use fixing all kinds of things in St. Louis, and yet they refuse to consider a PILOT program ⤵️

www.thenation.com/article/soci... @thenation.com

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Reposted by Mary Shannon

STLrainbow @stlrainbow.bsky.social · Aug 22

This building from a WashU for-profit entity is under a TIF and also received a personal property tax abatement this year. SLPS wasn't even notified of the abatement bill as required. Anyway, tax exempt WashU needs to join its wealthy university colleagues and pay PILOTs.

Sunshine Gerry @gconnolly314.bsky.social · Aug 21

Washington University should be ashamed! One of its numerous for-profit subsidies is appealing the assessment for #4140ForestPark

See my previous coverage of the project at:
#CortexTIF
#BOAbb139
#BOAbb140

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Mary Shannon @marymshannon.bsky.social · Aug 13

Our work to uncover & reduce harmful medical debt collection practices is growing!

Thanks to the Missouri Foundation for Health & @moconsumer.bsky.social, we're taking our efforts statewide. And we're hiring!

📌 Outreach Advocate: tinyurl.com/5epdz76w
📌 Social Media Specialist: tinyurl.com/7sd9euy7

Outreach Advocate - Medical Debt Project - The Rome Group

Job Title: Outreach Advocate – Medical Debt Project Reports To: [...]

tinyurl.com

Lawsuits for Unpaid Medical Bills and the Role of Physician Groups

Reposted by Mary Shannon

Fumiko Ladd Chino, MD FASCO @fumikochino.bsky.social · Aug 10

#Medicaldebt is an indicator of an inherent failure of our health system to protect the most vulnerable. Aggressively pursuing it does little to serve the financial bottom line of a hospital, while exposing the most vulnerable & their families to a lifetime of downstream consequences.

@jama.com

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Reposted by Mary Shannon

Fumiko Ladd Chino, MD FASCO @fumikochino.bsky.social · Aug 10

🚨This @jama.com NO 📄 examines St Louis physician practices who SUE their patients.

There are inequitable impacts of debt collection. Areas with ⬆️ % of Black residents & ⬇️ incomes...

face ⬆️lawsuits, ⬆️judgments, & ⬆️wage garnishment.

#Medicaldebt has disproportionate effects on certain communities.

This cross-sectional study examines the prevalence and impact of physician-driven medical debt lawsuits among Black, low-income, and other marginalized communities.

jamanetwork.com

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Mary Shannon @marymshannon.bsky.social · Aug 12

So grateful for your support in sharing this, Dr. Chino! Excited to share more from STL soon.

Health leaders warn of 'domino effect' from Medicaid changes at St. Louis roundtable

Reposted by Mary Shannon

St. Louis Public Radio @stlpublicradio.bsky.social · Jul 31

Representatives from St. Louis-area hospitals and clinics think new changes to Medicaid will lead to issues for patients, even those who don’t rely on the government-sponsored health insurance.

Around two dozen people from local health organizations aired concerns Wednesday at a roundtable in downtown St. Louis convened by U.S. Rep. Wesley Bell.

www.stlpr.org

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Mary Shannon @marymshannon.bsky.social · Jul 25

11/ I owe enormous gratitude to the Center for Social Development at WashU & @moconsumer.bsky.social for their encouragement, insight, and belief in the project, especially Dr. Michael Sherraden, Chris Leiker, Sandra Padgett, & Ed Weisbart. This work wouldn't have been possible without them.

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Mary Shannon @marymshannon.bsky.social · Jul 25

10/ The pattern is clear: tax-exempt, mission-driven institutions suing low-income, mostly Black communities over small sums. We hope this research contributes to a more equitable system.

Read the full study here: ja.ma/3In6gkj

#MedicalDebt #HealthEquity #STL

Lawsuits for Unpaid Medical Bills and the Role of Physician Groups

This cross-sectional study examines the prevalence and impact of physician-driven medical debt lawsuits among Black, low-income, and other marginalized communities.

ja.ma

Mary Shannon @marymshannon.bsky.social · Jul 25

9/ These lawsuits weren't filed by hospitals, but by university-affiliated physician groups, raising serious questions about institutional values, charity care, and community impact.

Mary Shannon @marymshannon.bsky.social · Jul 25

8/ Wage garnishment orders were even issued against employees of local hospital systems and against the universities themselves.

Mary Shannon @marymshannon.bsky.social · Jul 25

7/ The burden wasn't equally shared:
🔹 Majority-Black ZIP codes represent 22% of the region's population, but they accounted for:
🔸 41% of lawsuits
🔸 47% of total judgments
🔸 48% of wage garnishments

A stacked bar chart showing distribution of medical debt lawsuits and legal outcomes by ZIP code racial majority: Majority-Black zip codes, home to 21.9% of the region’s population (286 087 individuals), accounted for 392 identified lawsuits (41.1%), $488 352.10 in judgment totals (47.3%), and 203 wage garnishments (48.0%). Majority-White zip codes, home to 70.8% of the region’s population (924 397 individuals), saw 420 lawsuits (44.0%), $421 515.83 in judgment totals (40.8%), and 160 wage garnishments (37.8%).

Mary Shannon @marymshannon.bsky.social · Jul 25

6/ Here's what we found:
🔹55% of lawsuits led to judgments
🔹87% of those were default judgments (the patient didn’t appear)
🔹The average judgment: just under $2,000
🔹The smallest: $104

A Sankey diagram showing the final outcomes of 973 lawsuits: 531 resulted in judgments, of which 462 were default judgments, 66 were consent judgments, and 3 carried the disposition "tried by court - civil." Other potential case outcomes included: Dismissed (346), Not Disposed (61), Change of Venue (34) and Structured Settlement (1).

Mary Shannon @marymshannon.bsky.social · Jul 25

5/ We carried out this work independently and without funding. No grants, no institutional affiliation — just a Google spreadsheet, a lot of late nights, and a few social workers committed to uncovering and understanding the issue in our community.

Mary Shannon @marymshannon.bsky.social · Jul 25

4/ That discovery became a years-long project. With my co-authors Kathryn Koch and @mollywm.bsky.social we tracked and analyzed 973 lawsuits between January 2020 and May 2023. Our findings were just published in @jamanetworkopen.com.

Mary Shannon @marymshannon.bsky.social · Jul 25

3/ Curious and concerned, I turned to Missouri's court database, Case.net. I found not just a few lawsuits, but hundreds — mostly filed by physician groups affiliated with SLU, and also WashU. I decided then to start building a dataset.

Mary Shannon @marymshannon.bsky.social · Jul 25

2/ I'd spent years helping patients navigate complex billing & financial assistance systems, but I had never seen someone taken to court. I couldn't understand how this aligned with the Jesuit values I'd been taught at SLU...

Mary Shannon @marymshannon.bsky.social · Jul 25

1/ In 2020 while working at a non-profit health clinic in St. Louis, I encountered a patient being sued over unpaid medical bills. When I looked closer at the summons, I saw the plaintiff was my alma mater: Saint Louis University. 🧵