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Politics & Government

Studies: Hospitals fare better in states that expand Medicaid

By Tony Pugh - McClatchy Washington Bureau

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April 30, 2015 10:30 AM

- In states that expanded eligibility for Medicaid, hospitals that handle large numbers of low-income patients are faring better under the Affordable Care Act than those in states that haven't, according to two new reports released Thursday by the Kaiser Family Foundation.

The findings suggest that the health law, in states where it's fully implemented, is helping hospitals cut their uncompensated care costs, see fewer uninsured patients and increase their revenue from Medicaid, the state/federal health plan for the poor.

One study looked at the experiences of Ascension Health, a non-profit Catholic health system with 131 hospitals in 16 states and the District of Columbia.

Kaiser researchers found that Ascension hospitals in Medicaid-expansion states saw a 32-percent decline in visits by uninsured patients compared to just a 4-percent decline at their hospitals in non-expansion states.

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In addition, Ascension's charity care costs fell by 40 percent at their hospitals in expansion states compared to just a 6-percent decline at their facilities in non-expansion states.

More patients with Medicaid coverage appears to be the reason that Ascension's expansion-state facilities fared better.

From 2013 to 2014, those facilities saw a 7-percent increase in discharged patients whose bills were paid by Medicaid compared to just a one-percent increase for their hospitals in non-expansion states. Ascension's expansion-state facilities also saw larger increases in their operating margins.

In a separate study of nine safety-net hospital systems across the country, Kaiser found that five located in Medicaid-expansion states substantially increased their revenue from the program, while substantially reducing the amount of charity care they provided.

The five hospitals are: Cook County Health and Hospital System in Chicago; Denver Health; San Francisco General Hospital; Santa Clara Valley Health and Hospital System in San Jose, Ca. and University Medical Center of Southern Nevada in Las Vegas.

Harris Health System in Houston, Texas - a state that did not expand Medicaid - also saw their Medicaid revenue increase modestly and their charity care decline.

Reports:

"How Are Hospitals Faring Under the Affordable Care Act"

" Evolving Picture of Nine Safety-Net Hospitals: Implications of the ACA and Other Strategies"

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