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As debate continues in states that are still grappling with whether to embrace the Medicaid expansion, preliminary data from expansion states shows hospitals and health systems are beginning to see the benefits.
The Colorado Hospital Association gathered Medicaid data from 465 hospitals in 30 states – 15 in Medicaid expansion states and 15 in non-expansion states. Overall, the study found that Medicaid charges increased in expansion states, while charity care and self-pay cases dropped sharply. Self-pay in expansions states dropped from 4.7% in first quarter 2013 to 3.1% in 2014, while non-expansion state rates remained at 5%. Charity care per hospital fell to $1.9 million from $2.8 million a year ago. Self-pay charges in Colorado dropped to 3.5%, a 30% decrease from last year, and charity care dropped 36.2% to $2.9 million.
Some safety net hospitals are also starting to see changes, according to Kaiser Health News. Harborview Medical Center in Seattle saw its uninsured patient population fall from 12% to 2% and is projecting a $20 million revenue gain this year for newly reimbursed care. Denver Health in Colorado and the University of Arkansas for Medical Sciences Hospital in Little Rock have seen their uninsured population cut by about half. Hospital systems such as HCA and Tenet Healthcare are also reporting declines in uninsured rates (though HCA saw an uninsured increase of 6% at its facilities in non-expansion states).
After all that went wrong with the initial rollout of the Affordable Care Act, it’s good to see signs that some aspects are working as intended. While it’s far too early to say if the changes will be sustained, it’ll be interesting to see whether these early numbers will make any non-expansion states reconsider.