Patient satisfaction and safety-net hospitals: carrots, not sticks, are a better approach.

نویسندگان

  • Katherine Neuhausen
  • Mitchell H Katz
چکیده

S AFETY-NET HOSPITALS (SNHS) PROVIDE A DISproportionate share of care to uninsured and Medicaid patients. Because they have few privately insured patients, SNHs cannot cover the costs of uncompensated care for the uninsured by charging higher fees to insured patients. As a result of the heavy burden of uncompensated care for the uninsured and inadequate Medicaid reimbursement rates, most SNHs have negative operating margins. Under the Patient Protection and Affordable Care Act (ACA), many uninsured patients will gain coverage. This increase in coverage will help SNHs because they will likely have more paying patients. However, another provision of the ACA, a reduction in the Medicaid and Medicare Disproportionate Share Hospital (DSH) programs, may result in SNHs losing more money than they gain through the insurance expansion. The DSH programs provide supplemental payments to hospitals that deliver a disproportionate volume of care to uninsured patients and Medicaid recipients. The ACA requires a $14 billion cut in Medicaid DSH and a $22 billion reduction in Medicare DSH payments from 2014 through 2019. These cuts could have a devastating effect on the already precarious finances of SNHs, especially if they are unable to attract or retain newly insured patients.

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عنوان ژورنال:
  • Archives of internal medicine

دوره 172 16  شماره 

صفحات  -

تاریخ انتشار 2012