What one lending company’s hospital contracts reveal about financing patient debt

With tens of millions of Americans burdened by medical debt, hospitals and other medical providers are increasingly shuttling their patients into loans serviced by banks, credit cards, and other financial services companies.

The arrangements have proven very profitable for lenders. But, as KFF Health News reported in November, the rise of the patient financing industry is often less welcome for patients, who can end up in loans that pile interest on top of what they owe for their medical care.

UNC Health in North Carolina, for example, historically did not charge interest on payment plans patients enrolled in to pay off their debts. But KFF Health News found that within two years of the public university health system signing a contract with AccessOne, a private equity-backed lender, to finance the plans, nearly half of its patients were in loans that charged interest.

The financial risks faced by patients and their families have sparked interest from federal regulators, including the Consumer Financial Protection Bureau. Last month, the Biden administration announced a new investigation into companies that finance medical care.

As federal scrutiny mounts, KFF Health News is posting contracts and other documents obtained through public records requests that illustrate AccessOne's arrangements with three public systems: UNC Health, Atrium Health, and AU Health.

Both UNC Health and Atrium Health redacted significant portions of their contracts, including key terms. AU Health provided its contract without redactions.

The documents can be found below.

-UNC Health began contracting with AccessOne in 2019. As of February 2022, more than 100,000 UNC patients were enrolled in an AccessOne plan. https://s3.documentcloud.org/documents/23897548/accessone-unc-contract.pdf

-Atrium Health, a nonprofit system with roots as a public hospital in Charlotte, North Carolina, signed its contract with AccessOne in 2014. https://s3.documentcloud.org/documents/23897549/accessone-atrium-health-contract.pdf

-AU Health, Georgia's main public university hospital system, has contracted with AccessOne since 2019. https://s3.documentcloud.org/documents/23897552/accessone-au-health-contract.pdf