Information on hospital financial assistance and billing and collection policies was gathered and analyzed by KHN researchers from publicly posted policies or from hospital officials who answered questions via email or telephone. The hospitals were randomly selected from an American Hospital Association directory of short-term, inpatient facilities serving the general public. KHN also researched policies at the top 20 hospitals in the U.S. News & World Report annual rankings and the largest public university medical systems in each state. (Some states do not have a public university medical center.) The 528 hospitals researched are a largely representative sample of about 10% of community hospitals in the U.S., paralleling the distribution of all hospitals by geography, size, and ownership type. In some cases, hospital policies were not available online. In these cases, researchers reached out to officials at each hospital to ask about policies and practices. Each hospital scorecard indicates whether information is from a written policy or from some other source, such as a hospital spokesperson. Officials at some institutions did not respond to multiple requests for information. In such cases, the hospital scorecard notes that policies are unclear or unavailable. If a hospital provided no written information and refused to provide a named source to whom information about the institution could be attributed, the policy is noted as “unclear.” Data was gathered between November 2021 and December 2022. Researchers who worked on the project were KHN’s Noam N. Levey and Megan Kalata and Dr. Margaret Ferguson, Anna Back, and Amber Cole, who were students at the Milken Institute School of Public Health at George Washington University.

Information is from written policies, unless otherwise noted. However, hospital policies and practices change. Over time hospitals close, change names, or merge with other institutions. If KHN learns that an entry is no longer accurate, it will update information that it verifies.