Two years ago, I wrote about how Escambia County had struggled with providing medical care to its uninsured residents for decades. The county’s three hospitals, Baptist Hospital, Ascension Sacred Heart and HCA Florida West, have taken leadership roles in improving residents’ health outcomes, but I showed how the burden of charity care had shifted significantly over the past decade.
Baptist and Sacred nearly evenly split the charity costs for years, with Sacred slightly ahead and HCA Florida West, a for-profit hospital, handling about $1 million annually, according to state reports. By 2023, Baptist ranked third behind Sacred and HCA Florida West, carrying only 17% of the hospitals’ charity care costs. Read “Who Cares-Our Hospitals’ Charity Costs.”
- In true “Rick Outzen” fashion, the story cost us Baptist Hospital’s advertising, but at least there’s always money in the banana stand. Or you could buy me a cup of coffee.
Changing Medicaid Landscape
The Florida Agency for Health Care Administration issued its new Low-Income Pool (LIP) spreadsheet, and Baptist has increased its charity care by $17 million, going from $11,973,566 to $29,230,147, since moving to its new state-of-the-art facility on Brent Lane. It has nearly doubled its percentage share of charity care, from 16.6% to 32%.
| 2020-21 | 2021-22 | 2022-23 | 2023-24 | 2024-25 | |
| Sacred Heart | 23,359,811 | 20,354,476 | 30,083,589 | 40,131,746 | 42,191,719 |
| Baptist | 11,475,492 | 12,807,685 | 13,065,131 | 11,973,566 | 29,230,147 |
| West Florida | 1,128,216 | 686,944 | 16,827,196 | 20,172,683 | 19,820,399 |
| 35,963,519 | 33,849,105 | 59,975,916 | 72,277,995 | 91,242,265 | |
| Percentage | |||||
| Sacred Heart | 65.0% | 60.1% | 50.2% | 55.5% | 46.2% |
| Baptist | 31.9% | 37.8% | 21.8% | 16.6% | 32.0% |
| West Florida | 3.1% | 2.0% | 28.1% | 27.9% | 21.7% |
Background: The state of Florida tracks hospitals’ charity care costs for the Low Income Pool funding. In 2005, President George W. Bush established Low Income Pool (LIP) funding to support hospitals and safety net providers who care for the uninsured.
- Since 2017, the Florida Agency for Health Care Administration (ACHA) has published an annual LIP Model Summary that shows how the program distributes funds to hospitals based on their charity care cost. Hospitals are ranked from high to low based on their percentage of charity care costs to commercial costs. The hospital charity costs are taken from the Florida Hospital Uniform Reporting System. It’s the only independent source we could find to determine charity care for hospitals.
But There’s a Problem
Baptist Hospital appears to have a track record of exaggerating its charity care. When I wrote “Who Care,” Baptist had published a Community Impact Report At-A-Glance on its website that lists its charity care as $21.95 million for FY 2021. The LIP Model Summary for 2023-24 also used 2021 data, but it showed the charity costs as $11.97 million.
In June, Baptist Vice President KC Gartman told the Escambia County Commission that her organization could not contribute any more to the demolition of its old hospital.
Commissioner Chair Mike Kohler cited the board’s legislative action a few years ago that gives the hospital an additional $14 million annually. Gartman acknowledged this money but said it was already being used to help offset the $61 million in charity care the hospital provides.
- While we saw Total Charitable Care grow 26% from 2023-24 to 2024-25, we need to see Total Charitable Care increase to $184 million for Escambia County, which is more than double, for Baptist’s third share of Charitable Care to grow to $61 million. I’m not saying it’s impossible, but…
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