Uncompensated care lower in Medicaid expansion states: 5 things to know

Practice Management

States with Medicaid expansion experience less uncompensated care than before the expansion, but that’s not true for hospitals in states without Medicaid expansion, according to Health Affairs.

The Affordable Care Act was designed to decrease uncompensated care at hospitals when uninsured patients receive care. But not all states expanded Medicaid. Here are five things to know:


1. The study authors estimated that states with expanded Medicaid saw uncompensated care costs decrease from 4.1 percentage points to 3.1 percentage points.


2. Medicaid expansion states reported larger reductions at hospitals with higher pre-ACA uncompensated care burdens.


3. The estimates suggest uncompensated care in non-Medicaid expansion states would have decreased from 5.7 percentage points to 4 percentage points of operating costs.


4. The study authors concluded, “while the ACA decreased the variation in uncompensated care across hospitals within Medicaid expansion states, the difference between expansion and non-expansion states increased substantially.”


5. The authors suggest if policymakers shift uncompensated care burden they could affect other hospital decisions in addition to distributing supplemental public funding to hospitals.


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