Hospitals see blue-red divide early into Obamacare’s coverage expansion

[DonViejo]

Source: Washington Post

BY JASON MILLMAN
May 12 at 1:22 pm

A few months into Obamacare's coverage expansion, there's been plenty of debate about where the millions of newly insured have obtained coverage — whether through the law's exchanges, directly from an insurer, through expanded Medicaid or through an employer. The health-care law's immediate impact is a little more clear in hospitals, which are starting to report who's coming through their doors during the first months of expanded coverage under the Affordable Care Act.

I went through the last couple of weeks of earnings calls for publicly traded hospitals, who are reporting their first full quarter of results since the ACA took full effect. One thing that stood out: They're reporting a blue state-red state divide in the kinds of patients they're seeing.

The blue-red divide in Medicaid expansion

The Hospital Corporation of America, which has facilities in 20 states, reported a big gap in Medicaid and uninsured admissions between expansion and non-expansion states. In the four states it operates where Medicaid expanded under the ACA, the company saw a 22.3 percent growth in Medicaid admissions, compared to a 1.3 percent decline in non-expansion states. The company also had a 29 percent decline in uninsured admissions in the expansion states, while non-expansion states experienced 5.9 percent growth in uninsured admissions, chief financial officer William Rutherford said.

Community Health Systems, with facilities in 29 states, also noticed an expansion gap. In expansion states it serves, CHS said it saw self-pay admissions drop 28 percent while Medicaid admissions increased by 4 percent. Self-pay emergency room visits decreased 16 percent in expansion states, but they increased in non-expansion states, the company said in its earnings call last week.

-snip-

Read more: http://www.washingtonpost.com/blogs/wonkblog/wp/2014/05/12/hospitals-see-blue-red-divide-early-into-obamacares-coverage-expansion/

[Swede Atlanta]

1. I guess we will have to see how this plays out......

these initial numbers are hard to read. By expanding Medicaid you are giving people who previously did not have health insurance coverage to see a doctor without relying on the emergency room/hospital as medical coverage.

Perhaps it will take some time to get those covered to start to see doctors as preventive or early treatment options rather than waiting until things become critical and they have to be admitted to a hospital. On the other hand perhaps now those that were sick but did not want to fight the hospital bureaucracy are coming out of the shadows and receiving the care they need.

[okaawhatever]

7. Yes, i'm worried about the GOP harping on the first year or two numbers. There will be a short term

spike but once everyone gets the treatment they've been putting off we'll see a decline. Medicaid was up last month 9%. Don't know if that is what the planned for. It also doesn't take into account that medicare/medicaid taxes went up on the wealthy to offset the costs. You won't hear a net number there, only the increase in funding.

[cynzke]

8. Since Chronic Illness

is what drives up the cost of health care, and in relation to it, insurance premiums; the ACA preventive care measure attempt to curb that rise. Up to now, health care and insurance respond mainly to the aftermath of health neglect, when the cost is proportional to treatment. As health care via ACA preventive care now encourages staying healthy and starts treating chronic illness in its earlier stages, costs will start to curb down and insurance premiums will follow. It will take time for these ACA measure to register a cost savings, but in time we will see a significant improvement/cut in health care costs.

[Thinkingabout]

2. When the emercency room traffic down this will bring down the cost since

Health care through the emergency room is most costly. It should also allow better flow of those in need of emergency services.

Dammit, Obama, you are hurting GOP talking points, here comes more Benghazi investigations.

[groundloop]

3. THIS needs to be publicized in all red state governor elections

For instance, here in Georgia our POS corrupt governor not only refused Medicaid expansion but also pushed legislation which will make it virtually impossible for any future governor to do so by handing that authority over to the legislature. People need to see that the Medicaid expansion is actually helping them, and just maybe in some wet dream we can elect a Democratic majority to our legislature.

[EEO]

4. Only Ignorant Members of the Middle Class and Poor Vote Republican

There is no other reason one would vote against his own financial and overall well-being time after time.

[McCamy Taylor]

5. Rural hospitals are falling like dominos in red states. They are being replaced by minor emergency

centers that can demand cash up front and which will not treat heart attacks or strokes. If you live in a rural area in a red state, pretty soon you will die, even if you have health insurance, if you have a stroke or a heart attack.

[okaawhatever]

6. I will lmao when big hospital corps start funding Demoratic candidates instead of GOP ones. Big biz

finally found a regulation they like.

[wordpix]

9. My big concern as a cancer patient is the inflated bills, e.g $41K per chemo round

is what Yale New Haven Hosp. charges for each chemo infusion. I found an NIH report from 2012 stating that the real cost of my specific chemo round (one infusion over 46 hr) featuring drugs that have been around since the 1950's + administration (nurses, pharmacist, lab techs, scheduler) is $3400. Doctor's bill is separate and not included in the $40K.

I am scheduled for 12 rounds so with doctor and other incremental bills, the chemo bills will be at least $1/2 MILLION . This for old drugs, easily obtained and administered.

I have been in contact with state health directors and one said that while the bills "raised eyebrows," it's really an inflated number since insurance cos. only go by the "allowed amount." The "allowed amount" for my chemo round 2 was $24K, not $41K. Of that amt. my insurance co. charged me $3500. Not bad compared to $24K but actually, $3400 is the full amt. of the true cost of a chemo round according to NIH. And I have to do 2 rounds/mo = 7000/mo. Rather steep for a middle income wage earner who is not working now due to cancer and treatments.

There are certainly some billing shenanigans going on here and I have been trying to make my state, congressmen and media aware. I am wondering what portion of these inflated bills is paid for by Medicare/Medicaid/ACA subsidies, i.e. the American public.