Uncompensated Care

Frequently Asked Questions

• How is uncompensated care defined and how much does MD Anderson provide?
• How does MD Anderson serve the low-income population?
• Who is eligible to receive MD Anderson financial assistance?
• How does MD Anderson help in Harris County?
• What lies ahead?

How is uncompensated care defined and how much does MD Anderson provide?

In 2010, at the direction of the Texas Legislature, a new way for Texas hospitals to report total uncompensated care from all sources was adopted by the Texas Health and Human Services Commission. The formula is designed to provide a realistic picture of the impact on hospitals of providing care for which they are incurring unreimbursed costs.

Uncompensated care in Texas includes estimated unreimbursed costs for the uninsured (patients with no source of third-party insurance who qualify for direct financial assistance provided by MD Anderson) and the underinsured (those with insurance who, after contractual adjustment and third-party payments, have a responsibility to pay for an amount but are unable to pay). Uncompensated care also includes unreimbursed costs from government-sponsored health programs such as Medicare, Medicaid, Children’s Health Insurance Program (CHIP), county indigent programs and other state or locally sponsored programs.

Using the State of Texas definition, MD Anderson provided an estimated $319 million in uncompensated care for more than 78,000 patients with cancer in Fiscal Year 2023 (Sept. 1, 2022 - Aug. 31, 2023).

How does MD Anderson serve the low-income population?

MD Anderson has a long tradition of providing quality cancer care for many low-income residents of Texas.

In FY23, MD Anderson provided care to 398 people who primarily had no third-party insurance and who qualified for partial or full financial assistance under MD Anderson’s patient financial assistance program. In addition, MD Anderson provided care to more than 78,000 people whose primary source of insurance coverage was a state or locally sponsored governmental program such as Medicare, Medicaid, CHIP, Harris County Hospital District or other Texas county-specific indigent program

For the past 30 years, MD Anderson also has provided cancer services at Lyndon B. Johnson General Hospital and Outpatient Center for low-income Harris County residents. This program is staffed by MD Anderson faculty physicians, nurses and others at an annual cost to MD Anderson of over $6.7 million. In FY23, The MD Anderson program at LBJ General Hospital performed 1,200 new patient, 13,000 follow-up patient, and 1,400 inpatient visits.

In FY23, 15 MD Anderson faculty physicians, 9 MLPs, 2 genetic counselors, 4 pharmacists, 30 oncology physician fellows, 5 administrative staff, and research team staffed the oncology services at LBJ at a cost to MD Anderson of over $6.7 million.

Who is eligible to receive MD Anderson financial assistance?

Eligibility requirements for financial assistance by MD Anderson include: 

• U.S. citizenship or designated legal status
• Texas residency
• Low income and limited financial assets

Eligibility policies are established by MD Anderson and approved by The University of Texas System. To learn more about eligibility for financial assistance from MD Anderson, review the Patient Financial Assistance flier, (Spanish), (Vietnamese) and Patient Financial Assistance application, (Spanish), (Vietnamese).

How does MD Anderson help in Harris County?

To assist the large number of charity patients from Harris County who need cancer care, MD Anderson funds medical, urologic and gynecologic oncology services at LBJ General Hospital operated by the Harris County Hospital District dba Harris Health System.

In FY22, 17 MD Anderson faculty physicians, 8 MLP’s, 3 genetic counselors, 4 pharmacists, 40 oncology physician fellows and a number of research nurses and regulatory and data coordinators staffed the oncology services at LBJ at a cost to MD Anderson of over $4.9 million.

Some low-income patients from Harris County are not treated at LBJ and are referred to MD Anderson when they need highly specialized services or technologies. These patients include children and adolescents with cancer, adults with complex malignancies such as leukemia, pancreatic cancer and sarcomas, and candidates for blood and marrow transplantation. 

What lies ahead?  

• An estimated 4.8 million Texans, 16.6% of the state’s population, are without health insurance, the highest percentage of uninsured citizens in the country. (1)
• It is estimated that 14% of Texans are living in poverty. (2)
• The population of Texas is expected to increase to 40.6 million in 2050 and to 44.4 million by 2060.(3)'
• Texans 65 or older likely will make up 20.2% of the state’s population by 2060, compared to 13.8% in 2023.(4)

Cancer care costs are still expected to grow significantly and a number of Texas residents will either choose not to purchase insurance or will not be eligible for coverage under the Affordable Care Act. Regardless of the ultimate direction of federal health programs, MD Anderson remains committed to providing care for low-income Texas residents.

1. U.S. Census Bureau, 2022 American Community Survey 1 – Year Estimates (Table S2701) (ACS)
2. U.S. Census Bureau, 2022 American Community Survey 1 – Year Estimates (Table S1701) (ACS)
3. Texas Demographic Center (2022). Projections of the Total Population of Texas and Counties in Texas, 2020-2060 (1.0 Migration Scenario). Retrieved September 10, 2024, from https://demographics.texas.gov/Resources/TPEPP/Projections/2022/2022statetotsex_mig100.csv.
4. Texas Data Center and Office of the State Demographer, 2022. Age, Sex and Race/Ethnicity (ASRE) Population by Migration Scenario.