At Seattle’s largest
safety-net hospital, the proportion of uninsured patients fell from 12 percent
last year to an unprecedented low of 2 percent this spring—a drop expected to
boost Harborview Medical Center’s revenue by $20 million this year.
And the share of uninsured
patients was cut roughly in half this year at two other major safety net
hospitals—Denver Health in Colorado and the University of Arkansas for Medical
Sciences Hospital (UAMS) in Little Rock, Ark.
One of the biggest
beneficiaries of the health law’s expansion of coverage to more than 13 million
people this year has been the nation’s safety-net hospitals, which treat a
disproportionate share of poor and uninsured people and therefore face billions
of dollars in unpaid bills.
Such facilities had expected
to see a drop in uninsured patients seeking treatment, but the change has been
faster and deeper than most anticipated— at least in the 25 states that
expanded Medicaid in January, according to interviews with safety-net hospital
officials across the country.
“This is really phenomenal,” said
Ellen Kugler, executive director of the National Association of Urban
Hospitals, based in Sterling, Va., which represents inner-city safety net
institutions. “It shows the Affordable Care Act is clearly working in these
locations.”
Safety
net hospitals, most of which are government-owned or nonprofit, have typically
struggled financially because their urban locations mean they treat more
uninsured patients who show up in emergency rooms and cannot be turned away.
An Urban Institute study published in the
May edition of Health Affairs estimated
the costs of uncompensated care to hospitals were as high as $45 billion in
2013. Government programs helped defray 65 percent of those costs, the study
estimated. That left providers billions of dollars in the hole.
That’s
one of the reasons the hospital industry was among the first groups to
support President Barack Obama’s health plan, agreeing
to Medicare and Medicaid funding cuts exceeding $150 billion over a decade in
return for getting more paying patients to reduce their uncompensated care.
Many
hospital executives were unnerved, therefore, when the Supreme Court ruled in
2012 that states could not be forced to implement the Medicaid expansion and
nearly half of them have refused. As a result, hospitals in non-expansion
states are undergoing the funding cuts without a corresponding reduction in
uncompensated care.
Click here
for the full article in Kaiser Health News.