Wednesday, January 17, 2018

Rural hospitals in states that expanded Medicaid have been six times less likely to close than in states that didn't

Rural hospitals in states that expanded Medicaid were six times less likely to close than those in states that didn't, according to a study published in the January edition of the journal Health Affairs. "Richard Lindrooth, a professor at the Colorado School of Public Health and lead author of the study, says hospitals saw more people showing up to hospitals with that insurance — so Medicaid payments increased. That helped the hospitals' bottom line," John Daley reports for NPR.

Lindrooth and his team of researchers at the University of Colorado examined national hospital data and local market conditions from the four years leading up to the Patient Protection and Affordable Care Act (2008-2012) and the two years after the act took full effect with Medicaid expansion (2015-2016). They found that about half the hospital closures in non-expansion states could have been averted through Medicaid expansion. Expansion-state hospitals had more insured people, so they made more money and provided less free care, reducing cost margins, he told Daley.

Jason Clecker, CEO of Delta Memorial Hospital in rural western Colorado, said Medicaid expansion helped his hospital's finances. Between 2011 and 2016, the number of Medicaid patients seen in his hospital increased from 10 percent to 20 percent, and since the hospital had to provide less free care, it saved more than $3 million. "Our bad debt decreased significantly, and the uninsured rate decreased significantly," Cleckler told Daley. "It's pretty remarkable, and I would venture to say that most hospitals, even ones with a lower percentage of Medicaid, have experienced a similar story."

Cleckler also said Medicaid was a "mixed bag" for rural health care providers, since reimbursement rates are sometimes very low. Because of that, some providers won't accept or limit the number of Medicaid patients they'll accept.

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