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Aug. 18—Hospitals in the 24 states that have not expanded Medicaid would lose $167.8 billion over a decade, according to a new analysis.
The analysis, backed by two pro-expansion organizations, calculated the hospital losses based on the lack of Medicaid coverage of 6.7 million uninsured residents of those states, who would otherwise qualify under the eligibility expansion of the Affordable Care Act (ACA).
The U.S. Supreme Court made the expansion optional for states in its 2012 ruling upholding the law. Most Republican-led states have refused the expansion.
Hospital payments would comprise much of the $423.6 billion in federal Medicaid funds that the states would receive between 2013 and 2022, according to the report. The lost hospital revenue would provide a 31 percent boost in Medicaid funding during that time. Meanwhile, the expansion would cost those states $31.6 billion over the decade.
The largest hospital revenue losses among states declining to expand would be in Texas ($34.3 billion), Florida ($22.6 billion), and Georgia ($12.8 billion), according to the analysis.
Many hospital organizations have led the Medicaid expansion push in their states, partially over a concern that without the additional revenue their finances would suffer from steep cuts required by the ACA.
Between 2013 and 2022, the ACA requires a $22 billion cut in Medicaid disproportionate share hospital (DSH) payments, a $34 billion cut in Medicare DSH payments, and a $260 billion cut in Medicare fee-for-service payments.
In response to concerns that Congress could cut the federal funding of the Medicaid expansion below 90 percent and leave states with large, unfunded costs, the authors noted that Congress has lowered the federal share of Medicaid spending only once since 1980. Meanwhile, it has cut Medicaid eligibility, services, and provider payments more than 100 times.
Publication Date: Monday, August 18, 2014
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.
Scott Schmidt, vice president, Cerner RevWorks, LLC, shares insights on best practices for maximizing a revenue cycle management partnership.
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