Catholic health system growth threatens patient access, advocacy group argues

Catholic health system has significantly grown in the U.S. since 2001, a trend that could hamper patients’ ability to access some healthcare services that are prohibited by the church, according to a report released Tuesday.

The consumer advocacy group Community Catalyst found the 10 largest Catholic health systems control 394 short-term, acute-care hospitals, a 50% increase since 2001. In a growing number of communities, researchers found residents’ only acute-care options are hospitals that operate under Catholic restrictions. And the report—the fourth in a series under the group’s Women’s Health Program—emphasized the difficulty of learning what services are and are not offered at such facilities.

Like the rest of healthcare, Catholic providers have gravitated toward offering services outside of hospitals. The 10 largest Catholic health systems—including giants like Chicago-based CommonSpirit Health and St. Louis-based Ascension Health—operate 864 urgent care clinics, 385 ambulatory surgery centers and 274 physician groups, according to the report.

“The result of all this is that consumers are increasingly likely to encounter care that is restricted by Catholic doctrine, and they are unlikely to realize that ahead of time,” said Lois Uttley, an author of the report and director of Community Catalyst’s Women’s Health Program.

Catholic hospitals abide by a set of Catholic church rules called the Ethical and Religious Directives that prohibit providers from performing reproductive health services like contraception, sterilization, abortion and infertility services. The ERDs, which were updated in 2018, have also been interpreted to restrict the provision of gender transition surgery and physician aid-in-dying.

Catholic health systems in recent years have grown at a rapid pace, acquiring and partnering with hospitals and outpatient facilities. Their targets aren’t limited to fellow Catholic providers, either, they have added secular providers and have even partnered with insurance plans and public university systems.

The number of Catholic short-term acute-care hospitals in the U.S. grew almost 29% between 2001 and 2020, the report found. During that time, the number of non-Catholic hospitals declined almost 14%. And since Catholic hospitals tend to be larger than their secular counterparts, the report found one in six acute-care hospital beds in the U.S. is in a Catholic hospital.