Hospital Uncompensated Care Down

As was surely expected, reforms introduced through implementation of the Affordable Care Act have driven down uncompensated care costs for many hospitals.

How much?

A new study published by the Commonwealth Fund offers the following findings:

  • uncompensated care declines in expansion states are substantial relative to profit margins;
  • for every dollar of uncompensated care costs hospitals in expansion states had in 2013, the Affordable Care Act erased 41 cents by 2015; and
  • Medicaid expansion reduced uncompensated care burdens for safety-net hospitals that are not made whole by Medicaid disproportionate share payments (Medicaid DSH).

Learn more, including how the decline in uncompensated care costs affected different kinds of hospitals in different kinds of states, in the report “The Impact of the ACA’s Medicaid Expansion on Hospitals’ Uncompensated Care Burden and the Potential Effects of Repeal,” which can be found here, on the Commonwealth Fund’s web site.

Hospital Bad Debt Up in Ohio

While uncompensated care is down, bad debt is up at Ohio hospitals.

According to a new report from the Ohio Hospital Association, hospital bad debt rose in that state from $1.04 billion in FY 2013, when the state had not expanded its Medicaid program, to $1.23 billion in 2014, after Medicaid expansion had begun.


The increase was “…spurred by the growth in high deductible health plans,” the report states.

At the same time, what the association calls “charity care” fell from $1.03 billion to $809 million.

ohioIncreased bad debt as a result of the purchase of high-deductible health insurance is especially a challenge for urban safety-net hospitals because so many of the residents of the low-income communities they serve struggle even to pay for the lowest-cost health insurance.

To learn more go here to Healing Ohio Communities, the Ohio Hospital Association’s 2016 community benefit report.

Hospitals Reconsidering Charity Care Policies?

In the wake of Affordable Care Act policies that enhance access to health insurance, hospitals around the country are beginning to take a second look at their charity care policies.

iStock_000001497717XSmallSome are charging co-pays to uninsured patients; others are moving the line at which they provide free or subsidized care.

Such practices are not occurring in great numbers and do not yet constitute a trend, but they do reflect a growing concern among hospitals that some of their uninsured patients have options they are choosing not to exercise.

The New York Times has taken a look at a few hospitals that have reconsidered their long-time charity care policies.  Read its report here.