{"id":2431,"date":"2016-09-14T13:07:19","date_gmt":"2016-09-14T18:07:19","guid":{"rendered":"http:\/\/kbicblog.com\/blog\/healthcare-finance\/?p=2431"},"modified":"2016-09-15T12:58:52","modified_gmt":"2016-09-15T17:58:52","slug":"rural-hospitals-lack-medicaid-expansion","status":"publish","type":"post","link":"https:\/\/kbicblog.com\/healthcare-finance\/industry-news\/rural-hospitals-lack-medicaid-expansion\/","title":{"rendered":"Rural Hospitals Hurt By Lack of Medicaid Expansion, Study Says"},"content":{"rendered":"

\"Rural<\/a>It isn\u2019t news that in rural parts of the country, people have a harder time accessing good health care. But new evidence suggests opposition to a key part of the 2010 health overhaul could be adding to the gap.<\/p>\n

The finding comes from a study published Wednesday in the journal Health Affairs, which analyzes how the states\u2019 decisions on implementing the federal health law\u2019s expansion of Medicaid, a federal-state insurance program for low-income people, may be influencing rural hospitals\u2019 financial stability. Nineteen states opted not to join the expansion.<\/p>\n

Like what you’re reading? Click here<\/a> for more Healthcare Industry News.\u00a0<\/strong><\/em><\/p>\n

Rural hospitals have long argued they were hurt by the lack of Medicaid expansion, which leaves many of their patients without insurance coverage and strains the hospitals\u2019 ability to better serve the public. The study suggests they have a point.<\/p>\n

Specifically, the researchers, from the University of North Carolina Chapel Hill, found that rural hospitals saw an improved chance of turning a profit if they were in a state that expanded Medicaid \u2014\u00a0while in city-based hospitals, there was no improvement to overall profitability. Across the board, hospitals earned more if they were in a state where more people had coverage and saw declines in the level of uncompensated care they gave.<\/p>\n

To put it another way: All hospitals generally fared better under the larger Medicaid program, but there\u2019s more at stake for rural hospitals when the state expands coverage.<\/p>\n

The study looked at how expanding Medicaid affected hospital revenue, how many Medicaid patients they discharged, levels of uncompensated care the hospitals provided and how well the institutions did financially overall. It compared those effects in rural versus urban areas, across more than 14,000 annual cost reports from hospitals between January 2011 and December 2014, or a year after eligible states could have expanded their Medicaid programs.<\/p>\n

In states expanding Medicaid, rural hospitals saw a greater increase in Medicaid revenue than urban hospitals did. City-based facilities save a higher percentage than rural hospitals with the reduction in uncompensated care, though that change \u201cdid not translate into improved operating margins for urban hospitals,\u201d the study notes.<\/p>\n

Follow Kaye\/Bassman Healthcare Finance on Twitter<\/a>.\u00a0<\/strong><\/em><\/p>\n

One likely factor: Rural hospitals serve more low-income people \u2014\u00a0who weren\u2019t eligible for insurance before, but who got covered after the health law took effect. And rural hospitals are historically more likely to operate at a loss than are urban ones. So the chance to see increased revenue is greater than in a city-based hospital.<\/p>\n

It\u2019s important because hospital finances matter for consumers, too. In rural communities, hospitals are often among the largest employers<\/a>, and the main source of health care. Financial duress can affect what kind of services the facility offers.<\/p>\n

\u201cIf you\u2019re [a hospital] in a state that did expand Medicaid, obviously you\u2019re going to be experiencing lower amounts of uninsured. Your bad debts and charity care have gone down,\u201d said Brock Slabach, senior vice president at the National Rural Health Association. He was not involved in the study, although he is familiar with the research team\u2019s work. \u201cHas [that expense] gone to nothing? No. But it has helped.\u201d<\/p>\n

That\u2019s especially true for rural hospitals, Kaufman said, because they have narrower profit margins than do urban ones. Any squeeze on the budget \u201cis going to be more influential\u201d and may limit a hospital\u2019s offerings or quality.<\/p>\n

Meanwhile, rural hospitals are already facing financial strains, Slabach said. More than 70\u00a0have shut down since 2010. Still more are at risk of closure. Many endangered hospitals are in non-expansion states.<\/p>\n

How Medicaid affects rural and urban hospitals could influence other debates, the study authors said. For instance, the health law also is expected to cut so-called disproportionate health spending payments \u2013 cash infusions that support hospitals that treat low-income people, often in rural areas.<\/p>\n

\u201cThe hospitals rely on that funding to address uncompensated care,\u201d Kaufman said. In rural states that declined the expansion, uncompensated medical treatment poses a significant financial hurdle for hospitals.<\/p>\n

\u201cMedicaid expansion is not a random event. That\u2019s very important to consider here,\u201d said Holmes, another author of the study. \u201cThese are states that have decided to do it. There could be other elements\u201d at play.<\/p>\n","protected":false},"excerpt":{"rendered":"

It isn\u2019t news that in rural parts of the country, people have a harder time accessing good health care. But new evidence suggests opposition to a key part of the 2010 health overhaul could be adding to the gap. The finding comes from a study published Wednesday in the journal …<\/p>\n","protected":false},"author":26,"featured_media":2432,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"ngg_post_thumbnail":0,"footnotes":""},"categories":[308],"tags":[299,150,539,287,276,558,275,405,467,555,556,557],"class_list":["post-2431","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-industry-news","tag-affordable-care-act","tag-healthcare-costs","tag-healthcare-finance-blog","tag-healthcare-finance-news","tag-healthcare-finance-recruiting-practice","tag-journal-of-health-affairs","tag-kayebassman-international-corp","tag-medicaid","tag-medicaid-expansion","tag-rural-hospitals-hurt-by-lack-of-medicaid-expansion","tag-study-says","tag-university-of-north-carolina-chapel-hill","column","threecol","has-thumbnail"],"yoast_head":"\nRural Hospitals Hurt By Lack of Medicaid Expansion, Study Says<\/title>\n<meta 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