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More recently, the Internal Revenue Service issued guidelines that not-for-profit hospitals must cease "extraordinary" debt collection--including referring a patient account to a collection agency--unless the entity can demonstrate that the patient does not qualify for financial assistance, according to Forbes.

Wright and Blackwell said Texas should encourage more physicians to go into primary care in rural areas by expanding the loan repayment program, which offers some debt relief to doctors who do so.

A good chunk of Detroit’s debt problem is a health-costs problem. The Detroit Free Press notes that the city has $5.7 billion in unfunded retiree health-care liabilities, nearly a third of the city’s debt.

. It plans to transition its 19,389 retirees into the health law’s new marketplaces, saving the city somewhere between $27.5 million and $40 million annually.

. One report from the Pew Center for the States looked at 61 cities across the country and found that, taken together, they had $126.2 billion in health benefits promised to retirees. Only 6 percent of that amount – $8 billion – currently has funding.

Under the Affordable Care Act, health care providers may be rewarded if they demonstrate better health outcomes at lower costs.

“In the old world, doctors and hospitals were paid more if they did more,” Kannaday said. In the new model, doctors and hospitals that demonstrate they are providing quality care at a lower cost are rewarded financially, she said.

decline in charity care and bad debt with more patients