Crowe Horwath LLP, an accounting firm that runs a hospital financial performance tracking database, has evidence that Patient Protection and Affordable Care Act (PPACA) programs might be cutting use of hospital care.
Some observers have noted that PPACA-related drops in the uninsured rate seem to have slowed in recent months, especially in states that refused to take PPACA Medicaid expansion money. When Crowe Horwath analysts looked at hospital performance in August, they found signs that insured patients were having trouble paying their share of the bills.
But Crowe Horwath analysts say the Medicaid-expansion-state hospitals in its database reported fewer inpatient and outpatient admissions in September 2015 than they reported in September 2014, and that increases in average revenue per patient were modest.
In the Medicaid-expansion states, inpatient admissions decreased 1.4 percent and outpatient visits fell 2.8 percent. Average revenue per patient increased 2.7 percent for inpatients and just 1.1 percent for outpatients.
In the non-expansion states, outpatient visits fell 4.3 percent, but inpatient admissions increased 3.6 percent. Average revenue per patient was flat for inpatients and increased 4.1 percent for outpatients.