A big nonprofit hospital group has data supporting the idea that Patient Protection and Affordable Care Act of 2010 (PPACA) coverage changes helped its finances, rather than simply reducing the number of patients classified as being uninsured.
Analysts at the Henry J. Kaiser Family Foundation have used the data, from Ascension Health, to take a look at how the PPACA Medicaid coverage expansion program and other PPACA provisions, such as the new restrictions on medical underwriting and the PPACA exchange coverage subsidy program, might be affecting hospitals.
Some health market watchers have asked whether PPACA cost-control strategies will cut the average amount of provider reimbursement per patient so much that those reductions will offset the effects of any increases in insured patient volume, and leave providers worse off than they were before the major PPACA coverage expansion provisions took effect, in January 2014.
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The Kaiser analysts found evidence that PPACA may have reduced the financial burden of providing care for the poor in states that expanded Medicaid.
Ascension runs 131 acute-care hospitals. The Kaiser analysts had complete financial data for Ascension hospitals in eight jurisdictions that expanded Medicaid: Connecticut, Illinois, Maryland, Michigan, New York, Washington state and the District of Columbia.
The analysts also had data for eight Ascension hospitals that did not expand Medicaid: Alabama, Florida, Idaho, Indiana, Kansas, Oklahoma, Tennessee, Texas and Wisconsin.
The analysts compared data for the first three quarters of 2014 with data for the last three quarters of 2013.
Even in 2013, patients in the expansion states were more likely to have health coverage. The gap widened in 2014, as the already-small number of expansion state residents who lacked health coverage fell sharply. The number of Ascension hospital inpatients who were uninsured dropped 32 percent in the expansion states and just 4.4 percent in the non-expansion states.