Expanded health insurance coverage through the Affordable Care Act (ACA) is having a major impact on many of the nation’s hospitals through increases in the demand for care, increased patient revenues, and lower uncompensated care costs for the uninsured. This report examines the early experiences with the ACA by Ascension Health, the delivery subsidiary of the nation’s largest not-for-profit health system, Ascension. It finds that, overall, Ascension hospitals in Medicaid expansion states saw increased Medicaid discharges, increased Medicaid revenue, and decreased cost of care for the poor, while hospitals in non-expansion states saw a very small increase in Medicaid discharges, a decline in Medicaid revenue, and growth in cost of care to the poor.
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Safety-net hospitals are an integral part of the U.S. health care landscape, providing care to some of the nation’s most medically vulnerable populations, including Medicaid enrollees and the uninsured. With the implementation of the Affordable Care Act (ACA), the U.S. health care system is rapidly changing, and safety-net hospitals need to make major adjustments to survive in the post-reform environment. This brief draws on interviews with executives at nine safety-net hospital systems and examines how their hospitals have fared since major coverage provisions of the ACA came into effect in January 2014. The brief also examines new and ongoing strategies that the hospitals are adopting in the face of a quickly changing health care environment. While acknowledging the importance of the ACA, executives at each system in the study noted that other non-ACA related factors have also shaped how their hospitals fared over the last year. The hospitals in the study were: Cook County Health and Hospital System (CCHHS); Denver Health (Denver Health); Harris Health System (Harris Health); New York City Health and Hospitals Corporation (HHC); Parkland Health and Hospital System (Parkland); Santa Clara Valley Health and Hospital System (SCVHHS); San Francisco General Hospital (SFGH); University Medical Center of Southern Nevada (UMC), and Virginia Commonwealth University Health System (VCU). These hospitals participated in two earlier related studies that examined how the systems were preparing for health care reform.
In his latest column for The Wall Street Journal’s Think Tank, Drew Altman and guest co-author Dana Goldman examine hospital productivity gains, and what they may mean for hospitals’ ability to absorb spending reductions. All previous columns by Drew Altman are available online.
In this column for The Wall Street Journal’s Think Tank, Drew Altman and guest co-author Dana Goldman examine hospital productivity gains, and what they may mean for hospitals’ ability to absorb spending reductions.
This Issue Brief describes the Medicare Hospital Readmission Reduction Program (HRRP), which penalizes hospitals that have relatively higher readmission rates, analyzes the impact of this program on Medicare patients and hospitals, and discusses several issues that have been raised regarding its implementation.
A new report, The Rising Cost of Living Longer: Analysis of Medicare Spending by Age for Beneficiaries in Traditional Medicare, from the Kaiser Family Foundation takes a detailed look at per person Medicare spending by age and by service among the nearly 30 million people covered by traditional Medicare in 2011
The Rising Cost of Living Longer: Analysis of Medicare Spending by Age for Beneficiaries in Traditional Medicare
This analysis provides a detailed look at per person Medicare spending on the nearly 30 million beneficiaries over age 65 who are enrolled in the traditional Medicare program. Among the key findings of the report is that per person spending rises with age, peaking at age 96. But this rise is not entirely explained by Medicare spending on end of life care, which declines with age. What Medicare spends money on also changes as beneficiaries age. Hospital care is the largest component of Medicare spending throughout the age curve, up to age 100, but there is less spending on physician services and more on home health, skilled nursing and hospice care as beneficiaries age.
This brief examines four safety-net hospitals to learn how they were preparing for the full implementation of the Affordable Care Act (ACA), in order to gain additional insight into the strategies being used and challenges being faced among safety-net hospitals across the country.
This brief provides some background on federal Medicaid Disproportionate Share Hospital (DSH) allotments, how DSH payments are affected by the Affordable Care Act (ACA), the methodology for the DSH reductions across states for FY 2014 and FY 2015 and a look at the implications of the reductions.
The Alliance for Health Reform and The Commonwealth Fund discusses the critical role of safety-net hospitals in providing care to vulnerable populations. Panelists will explore such questions as: Who does the safety-net system currently serve and how will this patient mix change as the health reform law plays out? How…