Atrium Health, a part of Advocate, has been labeled the most litigious hospital chain in North Carolina, having filed thousands of liens against patients' homes.

Legal challenges have arisen regarding Advocate Health's pricing and billing practices, with lawsuits alleging excessive charges and hidden fees for services, reflecting a broader trend of rising healthcare costs.

Serving approximately 5.4 million patients annually across six states, Advocate Health reported nearly $26 billion in revenues for the first nine months of 2024, representing a 13% increase from the previous year.

Patients like Linda Hanner and Robert Montbleau have shared their harrowing experiences with overwhelming medical debt, underscoring the urgent need for hospitals to collaborate with patients on managing healthcare costs.

In a move to alleviate some of the financial burden, Advocate Health is in the process of canceling debt judgments, with plans to complete this initiative in its Midwest region by mid-2025, although many patients have already faced significant financial losses.

Nationally, around 41% of U.S. adults, equating to 100 million people, are grappling with medical debt, prompting the Biden administration to announce a new rule aimed at removing unpaid medical bills from credit reports.

In recent years, Advocate Health has expanded through mergers, which has raised concerns about market dominance and competition, while also facing accusations of high pricing and predatory debt collection practices.

In September 2024, Advocate Health announced plans to cancel thousands of debt judgments, particularly affecting North Carolina, and has ceased filing new liens since 2022, with intentions to cancel 11,500 existing liens across five states.

Advocate Health, one of the largest hospital chains in the United States, is taking significant steps to address the medical debt crisis by enhancing its billing and collection practices while also increasing eligibility for charity care.

The health system has a troubling history, having sued over 4,400 patients for at least $74 million between 2008 and 2022, predominantly targeting low- and middle-income neighborhoods that are largely composed of people of color.

Patients have reported that Advocate Health's previous debt collection practices resulted in severe financial distress, draining savings, ruining credit scores, and even leading to bankruptcy, which in turn caused emotional and physical health issues.

Criticism has been directed at Advocate Health's debt collection methods, including the requirement for patients to establish payment plans through a medical credit card company that charges high interest rates.