Hospitals in New Hampshire and Utah are seeing significant spikes in levels of uncompensated care, a trend that could foretell similar financial issues for acute care providers in other parts of the country, the Valley (N.H.) News and the Salt Lake City Tribune reported.
In New Hampshire, the issue revolves around the way the state operates its disproportionate share program for hospitals that treat large numbers of Medicaid or uninsured patients.
According to the Valley News article, the state has been favoring smaller hospitals over larger facilities when distributing DSH funds. As a result, larger facilities such as Dartmouth-Hitchcock Medical Center received no DSH funds, although it spent more than $74 million on uncompensated or charity care, the newspaper reported.
"We have to find a way to solve that problem," Steve Ahnen, president of the New Hampshire Hospital Association, told the newspaper. "We clearly have to find a way of changing the trajectory of how the system works. It simply is broken and not sustainable."
The Granite State's hospitals are projected to spend $358 million in charity care, of which $305 million will go unreimbursed, according to the Valley News.
In Utah, the state's four major hospital systems have seen their charity and uncompensated care burden triple over the past nine years, reaching $698 million in 2012, according to the Tribune. At Intermountain Healthcare, which operates 19 hospitals statewide, the charity care/uncompensated care rate has grown from just over $100 million in 2003 to $511 million last year.
"Our commitment is to continue offering charity care. We believe we'll be able to meet the needs for the time being," Mikelle Moore, vice president of Intermountain's community benefit division, told the Tribune.
In California, the amount of charity care and bed debt has increased 50 percent between 2004 and 2010, according to California HealthLine, even as margins have increased in recent years.