Did the Medicaid expansion affect hospital finances in the US?
A newly released study in JAMA focuses on how the Medicaid expansion affected hospital finances in the US, though, and it's worth our time. IMPORTANCE The Affordable Care Act expanded Medicaid eligibility for millions of low-income adults.
How does the Affordable Care Act affect hospitals?
IMPORTANCE The Affordable Care Act expanded Medicaid eligibility for millions of low-income adults. The choice for states to expand Medicaid could affect the financial health of hospitals by decreasing the proportion of patient volume and unreimbursed expenses attributable to uninsured patients while increasing revenue from newly covered patients.
What are the outcomes of interest in hospital profitability?
The main outcomes of interest were uncompensated care, both as a total amount and as a percentage of total hospital expensed, as well as Medicaid revenue, operating margins, and excess margins (which are, evidently, an indication of profitability that includes more sources of income than just patient care).
What has been the impact of Medicare payments in the hospital system?
Reduced health care charges and insurance premiums. Better coordination of health care treatment, payment, and coverage. Increased sponsorship of health maintenance organizations and preferred provider organizations. Increased availability of services in nonhospital settings.
What impact did Medicare and Medicaid have on society?
Medicare and Medicaid have greatly reduced the number of uninsured Americans and have become the standard bearers for quality and innovation in American health care. Fifty years later, no other program has changed the lives of Americans more than Medicare and Medicaid.
How do hospitals determine prices?
Hospitals don't have uniform practices or guidelines for setting or changing prices. It is an administrative decision, largely independent of any market trends. One facility may raise prices for a procedure by 20%, while another keeps the cost low.
Why do hospitals charge different prices?
Here's what the New York Times found. Relatively few hospitals have complied with a new law requiring them to publish the previously "secret" prices they negotiate with insurers—but of those that have, a new analysis from the New York Times suggests that prices vary widely based on a given patient's insurance plan.
How does Medicare and Medicaid affect the economy?
In short, Medicaid adds billions of dollars in economic activity. The federal government boosts this activity by matching state Medicaid spending at least dollar for dollar, bringing new money into states.
What are the disadvantages of Medicaid?
Disadvantages of Medicaid They will have a decreased financial ability to opt for elective treatments, and they may not be able to pay for top brand drugs or other medical aids. Another financial concern is that medical practices cannot charge a fee when Medicaid patients miss appointments.
How are hospitals reimbursed by Medicare?
Hospitals are reimbursed for the care they provide Medicare patients by the Centers for Medicare and Medicaid Services (CMS) using a system of payment known as the inpatient prospective payment system (IPPS).
Why is price transparency important in hospitals?
Effective consumer-driven health care can become a reality, but only if consumers are well-informed about the cost and value of their therapeutic options. Price transparency initiatives are an important first step in promoting more efficient and effective health care.
What is the purpose of pricing clinical services?
The price not only ensures that the costs of delivering services are covered. Price adjustments are made to ensure coverage and access, for example, to health care providers in rural and remote areas.
Why are some hospitals more expensive than others?
This might be because in less competitive markets, hospitals can sometimes have greater market power, which allows them to charge higher prices to insurers and patients. In those markets, price may simply be a reflection of a hospital's ability to charge higher prices than it is a measure of quality.
Why can hospitals charge so much?
Why Is My Hospital Bill So Expensive? The cost of US healthcare is soaring. Elements that contribute to the high cost of medical bills include surprise medical bills, administrative costs, rising doctors' fees, the high cost of surgical procedures and diagnostic tests, and soaring drugs costs.
Why do hospitals charge so much more than insurance will pay?
And this explains why a hospital charges more than what you'd expect for services — because they're essentially raising the money from patients with insurance to cover the costs, or cost-shifting, to patients with no form of payment.
How many hospitals did Medicaid expand?
The nineteen states that expanded Medicaid included between 1200 and 1400 hospitals (depending on reported outcome), while the 25 states that did not expand Medicaid included between 2200 and 2400 hospitals. Hospitals in states where Medicaid expanded saw a decline in uncompensated care of $2.8 million on average.
Why is it important to expand Medicaid?
The choice for states to expand Medicaid could affect the financial health of hospitals by decreasing the proportion of patient volume and unreimbursed expenses attributable to uninsured patients while increasing revenue from newly covered patients. ...
Is Medicaid expansion part of the Affordable Care Act?
Almost no attention is being paid to Medicaid, or its expansion as part of the Affordable Care Act. A newly released study in JAMA focuses on how the Medicaid expansion affected hospital finances in the US, though, and it's worth our time.