Central Valley Hospitals Report Charity Care, Community Regional Leads

The Business Journal released an updated ranking detailing how medical centers across the Central Valley provided charity care and wrote off patient medical bills from January 1, 2024 through December 31, 2024. The statewide data, drawn from facilities in Fresno, Kings, Madera and Tulare counties, shows Community Regional Medical Center in Fresno at the top of the list with $94.07 million in charity care and $64.9 million in unpaid medical bills during 2024. The center also reported discharging 547 indigent inpatients in that period.

Clovis Community Medical Center ranked second, reporting $20.79 million in charity care and $26.27 million in unpaid patient medical bills. Kaweah Health Medical Center in Visalia placed third, followed by Saint Agnes Medical Center in Fresno and Kaiser Permanente Fresno in the fifth position. The list ranks hospitals by the amount of patient medical bills written off, offering a snapshot of how local hospitals shoulder unpaid costs while providing care to people who cannot afford treatment.

For Fresno County residents, the figures underscore both access and reliability concerns. Charity care programs are a critical safety net for patients with little to no insurance and those facing high out of pocket costs. Hospital staff encourage people who need help to apply for financial assistance, yet the persistence of large unpaid balances suggests barriers remain in enrollment, outreach or eligibility. High levels of written off debt also affect hospital finances, potentially influencing service availability, staffing and community health investments.

Public health implications extend beyond hospital balance sheets. When patients delay care because of cost, preventable conditions can worsen and emergency departments can become the default option. The concentration of charity care in a few large centers points to the essential role safety net hospitals play for lower income communities across the Central Valley.

Policymakers and health systems face decisions about how to strengthen financial assistance programs, improve enrollment in coverage such as Medi Cal where eligible, and address structural inequities that drive reliance on charity care. For families struggling with medical bills in Fresno County, the report documents both the compassion of local hospitals and the limits of current systems to ensure equitable access to care.