Hospitals see PPACA admissions boost

Executives at three publicly traded hospital companies say they see clear signs that Patient Protection and Affordable Care Act (PPACA) is changing the mix of incoming patients.

The executives — at HCA Holdings Inc. (NYSE:HCA), Tenet Healthcare (NYSE:THC), and Community Health Systems Inc. (NYSE:CYH) — talked about the effects of PPACA recently during conference calls with securities analysts.

Two major PPACA coverage expansion programs were supposed to start helping consumers pay for health care Jan. 1.

One provides federal funding for states that expand Medicaid eligibility. Some states took the money and expanded Medicaid, and other states did not.

The other is the PPACA public health insurance exchange program. Consumers can use the exchanges to buy “qualified health plan” (QHP) coverage from private insurers. Many moderate-income QHP buyers can use federal premium tax credits to reduce their share of the premiums. Some QHP buyers can get help with paying deductibles and coinsurance amounts.

The Medicaid expansion program is having a dramatic effect on admissions, the hospital company executives said.

Tenet, for example, found that admissions of patients with Medicaid increased 17 percent in Medicaid expansion states from the levels recorded in early 2013 and fell 1 percent in states that declined to expand Medicaid, according to a Tenet investor presentation.

Admissions of uninsured patients and patients who would be depending on charity fell 33 percent in the Medicaid expansion states and increased 2 percent in the non-expansion states.

The effect of Medicaid expansion on outpatient patient mix was similar, and the effect on the emergency room patient mix was bigger, Tenet said.

At HCA, Medicaid admissions grew 22 percent in Medicaid expansion states and fell 1.3 percent in non-expansion states. Admissions of uninsured patients fell 29 percent in the Medicaid expansion states and increased 5.9 percent in the other states.