Dive Brief:
- According to hospital data, in states where Medicaid expansion has occurred, many hospitals are seeing fewer self-pay and charity care patients.
- Two Capella hospitals are good examples: In Tennessee, which did not expand, one hospital saw visits to the emergency department increase by 2%, the number of self-pay patients rose by 1% and uncompensated care increased by 1.8% in the first half of 2014. In Oregon, which did expand, a sister hospital saw ED visits rise by 10%, but self-pay was down 65% and uncompensated care down by 51%.
- But there are also concerns for hospitals in expansion states: Demand is high from the pent-up needs of uninsured individuals and the low reimbursement rates of Medicaid threaten to strain hospitals.
Dive Insight:
A report by the Colorado Hospital Association in June found similar numbers. In expansion states, Medicaid patients seen increased by 3%, charity care dropped by 30% (averaging almost $1 million less per hospital) and self-pay was reduced by almost 2%. Other hospital associations have found that Medicaid expansion boosts the economy and increases production.
In the near future, it seems likely that a reduction in charity care and self-pay will provide a net increase in funds for hospitals in expansion states and help cover a loss of disproportionate share funds. Over time, however, the increase in patient volume, coupled with a potential net loss from Medicaid reimbursement could be a challenge for hospitals, particularly safety nets, which care for a large number of Medicaid patients.