The HRI analyzed the finances of HCA Holdings (Nashville, Tenn.), LifePoint Hospitals (Brentwood, Tenn.), Tenet Healthcare (Dallas), Community Health Systems (Franklin, Tenn.) and Universal Health Services (King of Prussia, Pa.), which, combined, represent 538 hospitals in 35 states.
Comparing same-facility admissions from the first half of 2013 with the first half of this year, hospitals in each of the for-profit health systems saw a decrease of the following percentages in self-pay patients:
HCA Holdings: -6.6%
LifePoint Hospitals: -30.3%
Tenet Healthcare: -6.5%
Community Health Systems: -14.7%
Universal Health Services: -9.3%
In expansion states, specifically, the rise in admissions of Medicaid patients versus the decrease in self-pay patients is substantial:
HCA Holdings: 32.0% rise in Medicaid vs. -48.0% decrease in self pay
Tenet Healthcare: 20.5% vs. -46.0%
Community Health Systems: 10.4% vs. -47.6%
To Chris Tholen, vice president of financial policy at the Colorado Hospital Association, the shift in patient mix was not surprising, but the degree of change was. “Everybody expected the increases, but I would say that these are bigger overall than what we would have thought.”
Additionally, the report found that in the 26 states and District of Columbia that expanded Medicaid under the Patient Protection and Affordable Care Act, hospitals experienced higher volumes and increased revenue. Meanwhile, hospitals in states that did not expand have seen just the opposite.
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