St. Louis-based physician groups are disproportionately filing lawsuits against people living in zipcodes with higher percentages of low-income and Black residents, according to a report published July 10 by JAMA Network Open and reported out by St. Louis Public Radio July 23.
The research analyzed publicly available records through the Missouri court case management system. The researchers identified medical debt lawsuits filed from January 2020 through May 2023 by the five largest physician groups in the St. Louis area. Two of the five groups appeared in court records. The analysis only included cases filed against individuals, excluding cases unrelated to medical debt, such as malpractice and breach of contract lawsuits.
Here’s 10 takeaways from the study:
1. Two physicians groups, WashU Medicine Physicians and SLUCare Physicians, brought almost 1,000 lawsuits seeking medical debt collections from patients between January 2020 and May 2023.
2. Of all lawsuits filed, about half resulted in judgments. Most were default judgements, and many decisions resulted in wage garnishments.
3. The average judgement was for approximately $2,000.
4. Majority-Black zipcodes, encompass 22% of the region’s population, accounted for 41% of judgement totals and 48% of wage garnishments.
5. Majority-white zipcodes, which encompass 71% of the region’s population, accounted for 44% of total lawsuits, 41% of judgement totals and 38%of wage garnishments.
6. The research revealed that majority-Black zipcodes had, on average, 17 more lawsuits and an additional $24,314 in judgement compared with majority-white zipcodes.
7. Each $1,000 increase in median income was associated with a .19 decrease in lawsuits and a $242 decrease in judgement.
8. “Our analysis raises questions about the alignment of St. Louis University and Washington University in St Louis, the primary plaintiffs, with community health goals,” the authors wrote in the research letter cited by SLPR. “Both universities report that the suits do not materially impact their financial stability. The same cannot be said for the patients sued.”
9. WashUCare Physicians told SLPR that those affected by the lawsuits represent a small portion of the patients that the medical group has worked with. During the time period of the study, WashUCare Physicians treated nearly 1.5 million patients and provided $752 million in uncompensated care.
10. St. Louis University spokesperson Clayton Berry told SLPR that the university sold SLUCare to St. Louis-based SSM Health, a Catholic, non-profit health system, in 2022, and no longer operates the physician group. The university did operate the physician group for approximately two-thirds of the study’s timeframe. SSM Health told the publication that the health system does not pursue wage garnishment, credit reporting or legal action to resolve unpaid medical debts.
