- While negotiations continue on the Republican plan to repeal and replace the Affordable Care Act (ACA), the uncertainty is causing some hospitals to delay capital projects, reduce hiring and cut costs, Reuters reports.
- With the prospect of a major overhaul of the ACA, hospitals are in a position of not knowing how many patients will be insured in the future or what services their plans will cover.
- Not all hospitals are putting their projects on pause, however, according to Becker’s Hospital Review. Kaiser Permanente, Cincinnati Children’s Hospital Medical Center and Rapid City (SD) Regional Health were among eight hospitals that announced or wrapped up plans to expand or upgrade facilities in the past week.
Hospitals executives have been sharing their concerns with lawmakers in Congress as it pushes forward with an ACA replacement. Their main concern is ensuring that funding eliminated by the ACA is restored. Among those funds are Medicare cuts and payments for treating uninsured and low-income patients.
And hospitals have reason for concern. According to the Urban Institute, repeal of the ACA could boost the amount of uncompensated costs past the $1 trillion mark over 10 years.
Hospitals in states that expanded Medicaid have seen positive financial results and don’t want that pattern reversed. However, hospitals are freezing capital expenses amid uncertainty over the ACA’s fate and what will replace it. Former CMS head Andy Slavitt referenced the concern in a burst of tweets last month about conversations he’d had with hospital executives. “People are baffled in the real world by the politics,” he said.
Slavitt was especially surprised by results of a poll that showed 39% of hospital executives are slowing hiring and 31% are cutting capital expenses because of uncertainty about the ACA’s future.
Jonathan Bush, CEO of athenahealth, told Healthcare Dive recently that he anticipates a leveling off or decrease in government subsidies for providers under the Trump administration, as the focus shifts to digital health solutions and alternative care settings. Those subsidy cuts, coupled with the changing market dynamics, could weaken hospitals’ ability to compete for patients and fill beds.