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May 9—The numbers of uninsured treated by for-profit health systems has dropped and admissions have increased as the first large insurance coverage expansions began this year under healthcare reform, company executives said.
Larry Cash, CFO of Community Health Systems, said in a recent investors call that it has seen a decrease in self-pay admissions since the beginning of the year, when private insurance and Medicaid coverage expansions under the Affordable Care Act (ACA) went into effect. Cash projected that the organization’s share of self-pay admissions will drop from 8 percent to 4 percent over a three-year period.
Similarly, Bill Carpenter, CEO of LifePoint Hospitals, said in a recent investor call that in the seven states that have both LifePoint hospitals and expanded Medicaid eligibility, as encouraged by the ACA, the share of Medicaid patients increased and numbers of self-pay patients decreased.
Cash said his system estimated at least a $10 million benefit from both the Medicaid expansion and the so-called woodwork effect, in which people eligible for Medicaid before the ACA expansion but who never enrolled finally signed up.
The Obama administration said 4.8 million more people have enrolled in Medicaid since October 2013 than signed up a year earlier, although officials acknowledged those numbers include reenrollments and woodwork enrollees.
Hospitals have led the push for ACA Medicaid eligibility expansion for all residents with incomes of up to 138 percent of the federal poverty level, which 26 states have undertaken.
In the earnings call, LifePoint executives estimated 80 percent of self-pay patients in states that have expanded Medicaid eligibility would qualify for coverage under the public insurance program, and about 80 percent of that eligible population enrolled.
Additionally, LifePoint reported 15 percent of its eligible patient population enrolled in a private health insurance plan offered through an ACA marketplace, which also helped reduce the number of uninsured patients.
In the four Medicaid expansion states where HCA has hospitals, the health system has seen Medicaid admission growth and a 29 percent decline in uninsured admissions. That compared with a 5.9 percent increase in uninsured admissions in HCA hospitals in non-expansion states.
Expansion of coverage to the uninsured through healthcare reform to-date is expected to cut hospital bad debt by 13 to 18 percent, according to a recent report by Bank of America Merrill Lynch.
Hospital officials said they expected a clearer picture of ACA impacts on patient volumes to emerge in the second half of the year.
Publication Date: Friday, May 09, 2014
Tom Myers, chief strategy officer, The SSI Group, discusses the shifting payment environment and how it affects providers' patient access and claims management processes.
Jeff Chester, senior vice president and chief revenue officer at Availity, shares his thoughts on "Revenue Cycle 2.0" and how to best meet its challenges.
Mitch Morris, vice chair and global leader, healthcare, Deloitte, and Michael O'Rourke, senior vice president and chief information officer, Catholic Health Initiatives (CHI), share perspectives on the need for transformational IT in health care today.
Brian Kueppers, founder and CEO, Apex, discusses the importance of a robust patient payment strategy in boosting organization revenue and enhancing patient satisfaction.
Brian Grazzini, CFO, HealthPort, describes the importance of efficient and compliant information exchange and audit management in helping HIM staff spend less time on paperwork and more on mission-critical projects.
Cindy Matthews, executive vice president, Community Hospital Corporation, discusses how rural and community hospitals can use collaborative partnering to position for success through tough market conditions.
Rick Heise, senior vice president, revenue cycle, at Cerner Corporation, discusses the importance of integrating clinical and financial data to excel in health care’s changing payment environment.
Russ Graney, founder and CEO for Aidin, and John Laursen, head of business development for Aidin, share insights on how to improve care transitions between acute and post-acute care settings and incentivize high-quality patient outcomes.
Scott Elston, strategic accounts manager, GE Healthcare Services, describes how substantial cost reduction in health care requires rethinking business strategy and asset use.
Robert Williams, MD, director, Deloitte Consulting LLP, and Arielle Freiberger, product strategist, ConvergeHEALTH by Deloitte, explain how sophisticated retrospective, real-time, and predictive data analytics can inform decision making to reduce costs and improve care.
Stuart Hanson, director of business development (healthcare solutions) at Citi Retail Services, discusses how improving the payment experience can benefit consumers and healthcare providers.
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