Medicaid expansion helps hospitals' bottom lines

Hospitals in states that expanded Medicaid as part of the Affordable Care Act report financial gains as more patients can now pay their bills, according to a Kaiser Health News report.

For example, at Washington's Harborview Medical Center, the percentage of uninsured patients has dropped 10 points to 4 percent in the wake of expansion, according to the report. Last year, the hospital provided about $200 million in uncompensated care.

"We anticipate our numbers for charity care this year will reduce by about 20 to 30 million," said Johnese Spisso, chief health system officer for UW Medicine, of which Harborview is a member, "and as we continue to get more patients signed up, we see that flattening."

A nationwide study in September found an increase in emergency department visits in expansion states, but hospitals in Harborview's position try to steer the newly insured away from costlier emergency care and toward primary care treatment, according to KHN.

"Over the many years that I've worked here, I've seen all too many scenarios where people present with cancer or with advanced heart disease or lung disease or strokes, and they go on for many years without access to care" said Richard Goss, M.D, Harborview's medical director. "When there's basic healthcare coverage, so many doors are opened." 

In states that expanded the program, hospital officials expect unpaid bills to drop $4.2 billion, according to KHN. In contrast, they will only fall about $1.5 billion in non-expansion states, due largely to people buying coverage on the exchanges.

But since the mid-term elections, many Republican-controlled states have signaled openness to expanding the program under certain conditions, according to a new FierceHealthPayer special report. Most will consider expanding Medicaid if recipients undergo certain screenings, pay premiums or obtain jobs as conditions of receiving any benefits.

To learn more:
- here's the report