Medicaid expansion skewing admission rates

The perception gap between red and blue states on expanding Medicaid eligibility hews very closely to hospital admissions, the Washington Post reported.

The earnings reports of the largest publicly-traded hospital chains show a huge difference in Medicaid-related admissions in states that have expanded program eligibility versus states that do not, according to the Post. The Hospital Corporation of America, for example, saw a 22.3 percent growth in Medicaid-related inpatient admissions in the four states that have expanded eligibility under the Affordable Care Act. In those states that did not expand Medicaid, admissions declined by 1.3 percent.

Tenet Healthcare Corp. reported a similar break: a 17 percent increase in Medicaid-related admissions in the states that expanded eligibility, while uninsured patient visits dropped 33 percent. In non-expansion states, Medicaid admissions dropped 1 percent, while uninsured care rose by 2 percent, according to the article.

Community Health Systems also said that self-pay admissions dropped 28 percent in expansion states, while self-pay emergency room visits expanded in states that declined to expand coverage, according to the article.

"They're getting more patients with Medicaid coverage, which reimburses at rates lower than private coverage, but still pays better than no insurance. And it suggests that patients with new coverage are seeking care," the Post reported.

By contrast, hospital operators in states that have not expanded Medicaid eligibility struggle with their margins, and some may have to close their doors, particularly those facilities located in rural areas. However, even a large operator such as the Cleveland Clinic struggles with maintaining the financial status quo.

The publicly-traded hospital systems also said that the boost in Medicaid admissions helped their bottom lines by reducing expenses related to uncompensated care.

Many hospital chains push for the relaxation of presumptive eligibility rules on a state-by-state basis, which would make enrollment of some demographic groups into Medicaid automatic, the Post noted.

To learn more:
- read the Washington Post article

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