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Undue Medical Debt Works with Ballad Health to Abolish Over $277M of Medical Debt 

Regional not-for-profit health system and national nonprofit demonstrate that Undue Medical Debt’s abolishment model can be effectively leveraged directly by community-minded healthcare providers 

[Undue Medical Debt, New York, NY – Tuesday, June 15, 2021] – Ballad Health and Undue Medical Debt (RIP) announced today a new agreement that will eliminate $277,974,370.31 worth of non-governmental payer medical debt (i.e., non-Medicare/Medicaid) for approximately 82,000 people previously served by Ballad Health. 

Undue is a national nonprofit that uses donated funds to purchase medical debts belonging to financially burdened individuals. Undue has historically acquired accounts from the secondary debt market, such as from debt buyers and collection agencies, in order to relieve the acquired debt. In July of 2020 the Department of Health and Human Services Office of the Inspector General issued Advisory Opinion #20-04, allowing hospitals and physician groups to sell or donate debts directly to Undue for the purpose of abolishing a patient’s liability under certain conditions.

Undue first approached Ballad Health in 2020. The health system and Undue worked together over the next year to evaluate the legal and technical considerations of the arrangement, with the knowledge it could serve as a test case for many other health systems nationwide.

“Since the completion of our merger in 2018, Ballad Health has implemented a number of new policies and programs to reduce the cost of care for uninsured and under-insured individuals, such as raising our eligibility for full charity from 200% to 225% of the federal poverty limit, reducing charges for urgent care services by 17% and increasing self-pay discounts to 85% off charges, and implementing presumptive eligibility which eliminates burdensome paperwork requirements for people to be considered for charity care,” said Lynn Krutak, Ballad Health chief financial officer. “It made sense for us to look at the Undue model to see if we could extend these efforts further.”

Ballad Health serves a 29-county area in rural Appalachia about the size of New Hampshire. Average per capita income is significantly lower than state and national averages while the burden of disease is much higher. Commercial payor mix hovers near 20 percent.

As part of its unique merger agreements with the State of Tennessee and the Commonwealth of Virginia, Ballad Health has committed to transforming from a traditional hospital-based system to a community health improvement organization. This includes significant new investments in community organizations and the creation of a 300-member community led Accountable Care Community, expansion of community health worker and navigation services for families with newborn children and uninsured individuals with chronic disease, and expansion of behavioral health services and the Ballad Health Niswonger Children’s Network. 

“We’ve screened over a hundred thousand individuals in our service area for food and housing insecurity, exposure to domestic violence and other health related social needs, and we’ve found again and again, many services exist to support these individuals and families, but as a system and community we previously haven’t connected with them appropriately,” said Anthony Keck, chief population health officer for Ballad Health. 

“Nearly everyone who will receive their debt abolishment through this collaboration with Undue Medical Debt qualifies for our updated charity care policy, but for various reasons they either did not qualify at the time or did not take advantage of it in prior years. By removing this burden of old debt, we hope to better engage with our patients, so they access care and other services when they need them without the fear of unmanageable expenses,” added Keck.

“This next phase of medical debt abolishment would not be possible without Ballad Health’s commitment to the betterment of its local communities and the generosity of all of our incredible local and national donors,” shared Undue ’s executive director Allison Sesso.

“Collaborating directly with healthcare providers allows us to abolish burdensome medical debts earlier in their life cycles and we encourage other community-minded doctors and hospitals to explore partnering with us so that together, we can continue to relieve the debt burden on individuals, and families, so they can have a fresh start.”


About Ballad Health

Ballad Health is an integrated community healthy improvement organization serving 29 counties of the Appalachian Highlands in Northeast Tennessee, Southwest Virginia, Northwest North Carolina and Southeast Kentucky. Our system of 21 hospitals, post-acute care and behavioral health services, and a large multi-specialty group physician practice works closely with an active independent medical community and community stakeholders to improve the health and well-being of close to one-million people.  By leading in the adoption of value-based payments, addressing health related social needs, funding clinical and health systems research, and committing to long-term investments in strong children and families in our region, Ballad Health is striving to become a national model for rural health and healthcare.  Learn more at www.BalladHealth.org.

About Undue Medical Debt

Since being founded in 2014 by two former debt collectors, Undue Medical Debt has acquired — and abolished — more than $4.5 billion of burdensome medical debt, helping over 2.7 million families by addressing a major social determinant of health: financial hardship. Undue partners with individuals, faith-based organizations, foundations and corporations and empowers their donors by converting every dollar donated into an average of $100 of medical debt abolished. Undue also partners with hospitals and health systems, physicians and other organizations to acquire medical debt for abolishment. Undue rose to national prominence on an episode of HBO’s “Last Week Tonight” with John Oliver in which Undue facilitated the abolishment of $15M in medical debt. In December of 2020 philanthropist MacKenzie Scott donated $50 million to the nonprofit to help uplift struggling communities. To learn more, visit https://unduemedicaldebt.org.