Hospitals say getting paid for previously uninsured folks has saved them from potential closure. The Goldwater Institute says hospitals are raking in the dough by also raising rates on the commercial side.The Arizona Hospital and Healthcare Association (AzHHA) publishes a report that tracks uncompensated care trends for Arizona Hospitals. Also in the report is information about the composition of AHCCCS members, hospital assessment and other key measures such as hospital margins and ED utilization. This report points to improved bottom lines and less uncompensated care since Medicaid expansion in January 2014.
Read the memo and report from AzHHA Senior VP and COO Jim Haynes July 2018 Hospital Financial Reports Arizona Hospital and Healthcare Association
The Goldwater Institute has published a policy paper and fact sheet warning states of the dangers of Medicaid expansion. You can also read about the history of AHCCCS and policy changes impacting enrollments and costs from the Goldwater Institute (GI) perspective.
The GI paper focuses largely on the cost shift that occurs when uncompensated care is high. GI contends that this was a major argument used for expanding Medicaid. Hospitals go to the healthplans and ask for more on commercial business, arguing that they cannot stay open without money to make up for the write-offs on the uninsured. More Medicaid enrollment should lower uncompensated care and thus the hospitals shouldn’t need to go to the healthplans and ask for increases. The Goldwater Institute points to extremely high increases in charges at hospitals since Medicaid expansion. This is based on data from the Healthcare Cost and Utilization Project, the American Hospital Association Annual Survey Database, and the Centers for Medicare and Medicaid Services’ Healthcare Cost Report Information System.
Publisher’s Note: This data is based largely on hospital charge information, which does not reflect the contractual agreements between plans and hospitals. Industry insiders admit that the “chargemaster” is largely a relic at most hospitals and does not reflect accurately the prices paid by insurers. Contracts set forth rates, and very few are based on charges. Are the hospitals still asking for and getting raises from the healthplans? These are confidential agreements that HCUP, the AHA and CMS and GI do not have. Only when we have real price transparency will we truly know what healthplans are paying for hospital care. My sources tell me that value-based networks are driving care out of the hospital and into outpatient settings. Are hospitals asking for raises because their volume is going down and their acuity level is going up? Why are they jacking up their chargemasters, when so few pay based on those rates?
Listen to a radio show with both perspectives on KJZZ NPR Radio with Naomi Lopez Bauman, The Goldwater Institute’s director of healthcare policy, and Greg Vigdor, CEO of the Arizona Hospital and Healthcare Association (AzHHA).
At least one rural hospital board member has voiced support of the expansion. Read a piece from Mignonne Hollis, Vice President of the Board at Canyon Vista Medical Center in Sierra Vista and Hertel Report member, which was published in the Herald Review.