C-suite feels ripple effect from Medicaid expansion, study says
Healthcare executives in Medicaid expansion states reported making investments to integrate and improve care delivery.
Arkansas is one of the four Medicaid expansion states who participated in the study.
Medicaid expansion is making a difference as to whether hospitals are investing in clinics, new equipment and hiring new staff, or looking at the status quo and layoffs, according to a recent report by Georgetown University Health Policy Institute.
Hospitals in Medicaid expansion states have realized a drop in uncompensated care; an increase in institutional financial security; new community efforts to integrate and improve care; and innovative programs to expand access to specialists, according to the study.
CEOs who head hospitals in both expansion and non-expansion states said they saw a drop in uninsured rates in expansion states that was not as dramatic in non-expansion states.
This has translated to a decline in uninsured patient stays by close to 40 percent. Non expansion states reported a decline of 2.9 percent.
For example Hospital Corporation of America providers in expansion states saw a 48 percent decline in uninsured admissions from 2013 to 2014, while HCA hospital in non-expansion states reported a 2 percent decline, the report said.
The rate has impacted the bottom line.
One federally-qualified health center went from a $2.5 million end-of-year loss prior to expansion to a $2.5 million surplus after, the report said.
A large hospital system in an expansion state said it went from a 0.1 percent margin to a 4 percent margin in the year after expansion.
[Also: Enrollment in Louisiana's Medicaid expansion begins Wednesday]
"Having a margin allows thinking about taking care of long-term needs," the study quoted one executive as saying.
Healthcare executives in Medicaid expansion states reported making investments to integrate and improve care delivery, while executives in non-expansion states were more likely to say the system remained status quo, according to the report.
Both execs cited access to specialty care as a priority, but those in expansion states had more new programs in that area.
Medicaid has not solved all problems, the report said. Providers in all states continued to have difficulty finding specialists who accept Medicaid, the authors said.
Currently, 31 states and the District of Columbia have opted to expand Medicaid coverage to uninsured residents with incomes below 138 percent of the federal poverty level.
[Also: Most Texans, Floridians want Medicaid expansion, survey shows]
For the study, the researchers spoke by phone to 11 leaders of hospital systems and federally qualified health centers in seven states.
Three of the states, Missouri, Tennessee and Utah had not expanded Medicaid; while four states had: Arkansas, Colorado, Kentucky and Nevada.
The major theme that emerged, the authors said was "Drops in uncompensated care and decreasing uninsured rates are having a positive ripple effect throughout the health system in expansion states while institutions in non-expansion states present a more mixed picture."
Twitter: @SusanJMorse
