AHA says uncompensated care rose slightly in 2013

Uncompensated care expenditures by hospitals increased for the 13th consecutive year in 2013, although the increase was relatively modest and was outstripped by moderations in total hospital operating expenses.

Costs for uncompensated care reached $46.4 billion in 2013, spead out among 4,974 hospitals, according to data from the American Hospital Association (AHA). The cost was $45.9 billion in 2012 among 4,999 hospitals.

That represents an overall increase of 1.1 percent in terms of straight dollar amount, and a 1.6 percent increase per hospital, which was exacerbated by the smaller number of hospitals reporting for the 2013 survey.

The increase was the smallest since 2009-2010, when uncompensated care costs jumped from $39.1 billion to $39.3 billion, or less than one-half of 1 percent.

Along with the modest increase in uncompensated care costs, the percentage of uncompensated care representing expenses decreased from 6.1 percent in 2012 to 5.9 percent in 2013.

The data does not include shortfalls on the cost of providing care to Medicare and Medicaid patients, according to The Hill. And most hospitals base uncompensated care on full charges rather than rates negotiated with public and private payers.

Uncompensated care levels have grown at a signifcant rate over the past decade. In 2003, it cost hospitals $24.9 billion and represented 5.5 percent of their overall expenses, according to the data, one of the the smallest ratios since the AHA began keeping records on uncompensated care levels in the early 1980s.

The AHA quietly issued its uncompensated care data last week without an accompanying statement from officials. However, it is likely that the ramping up of enrollments in Medicaid and commercial plans as part of the Affordable Care Act may have contributed to the smaller increase. States that expanded Medicaid eligibility, such as Arizona, saw overall uncompensated care burdens drop by a third on average, with some hospitals seeing drops of as much as 45 percent, FierceHealthFinance previously reported. 

By comparison, states that did not expand Medicaid eligibility, such as Virginia, have seen hospitals struggle with rising expenses--compounded by ACA-mandated cuts in the Disproportionate Share Hospital program.

To learn more:
- read the AHA data (.pdf)
- check out The Hill article