Report: Medicaid expansion resulting in fewer self-pay, charity cases

GREENWOOD VILLAGE – Hospitals in states where Medicaid expansion has taken place are seeing a reduction in self-pay and charity-care cases, according to a study released today Monday by the Colorado Hospital Association.

The study used data from 465 hospitals in 30 states t from the first quarter of 2014. In expansion states, hospitals experienced an increase in Medicaid patients of 29 percent, with a parallel 25 percent decrease in self-pay and a 30 percent decrease in charity care.

Medicaid expansion began in Colorado and other states that chose to expand Medicaid coverage under the Affordable Care Act on Jan. 1. The law authorizes new coverage levels that allow Coloradans earning up to 133 percent of the federal poverty level – $14,856 for an individual and $30,657 for a family of four – to enroll in Medicaid.

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More than 178,500 people enrolled in Medicaid from Oct. 1 to April 15, according to data provided by Connect for Health Colorado, the state’s health-insurance exchange.

“These findings not only affirm that more people are finding health-care coverage who didn’t have it before, but also that it is having a positive impact by reducing the levels of uncompensated care at hospitals, which could further efforts to reduce health-care costs,´ said Steven J. Summer, president and chief executive of the Colorado Hospital Association.

Uncompensated care is health care provided by a hospital for which no payment was received from the patient or the insurer. The cost totaled about $500 million for Colorado hospitals in 2012, according to CHA.

The losses must either be absorbed by the hospitals, ultimately resulting in a decrease in access to care, or shifted to private insurers in a practice called “cost-shifting,” which is considered one of the driving forces behind continually escalating health-care costs.