Wednesday, February 21, 2018

Repeal of ACA's individual mandate means that hospitals could be stuck with more bad debt for treating overdoses

Drug overdoses could take a bigger bite out of hospitals' bottom lines soon, thanks to the repeal of the Patient Protection and Affordable Care Act's individual mandate. Hospitals have been mostly insulated from the cost of treating overdoses because almost everyone had insurance. Now that the mandate has been repealed, patients without insurance will likely need to be treated for overdoses and won't be able to pay their bills.

The rising cost of treating overdoses, and their increasing frequency, will likely exacerbate hospitals' financial woes, especially in rural areas where hospitals can barely afford to stay open. According to a 2017 study, "The average cost to treat overdose patients admitted to hospital intensive care units climbed from $58,517 in 2009 to $92,408 in 2015—a 58 percent hike," Kristen Schorsch reports for Modern Healthcare. And in Illinois alone, the steep rise in ER visits was mostly because of heroin.

Addicts can be expensive patients for hospitals in other ways too. Opioids can trigger other health problems that require medical attention, such as accidents, or asthma flareups caused by heroin, which can reduce the number of breaths a person takes per minute. And an Illinois hospital reports that nearly 40 percent of the patients admitted for opioid-related conditions were readmitted soon afterward. "That's a problem for hospitals, too, because the federal government financially penalizes them if patients come back too quickly after they're discharged," Schorsch reports.

Some rural hospitals may unintentionally contribute to addiction rates: a doctor may write a patient a prescription for a larger number of painkillers if she knows the patient lives far away and can't come back frequently to refill prescriptions. And rural residents tend to work in factories or on farms, where painful injuries are more likely.

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