Two newspapers teamed up to explore the connection between nonprofit hospitals' market share and expansion plans, especially as they relate to patients' insurance status.
The analysis from the Milwaukee Journal Sentinel and Pittsburgh Post-Gazette found nearly two-thirds of the approximately 230 hospitals that have opened across the U.S. since 2000 are in wealthier areas. Wisconsin is the focus for much of the article, as health systems in the Milwaukee area have spent more than $750 million in the past seven years to build hospitals and clinics in the city's suburbs.
Although hospital systems often say profits from their suburban sites of care help fund programs in some poorer neighborhoods, reporters with the Milwaukee Journal Sentinel and Pittsburgh Post-Gazette didn't exactly find supporting evidence.
For instance, no health system other than Children's Hospital of Wisconsin has opened a primary care clinic in a low-income neighborhood in Wisconsin in recent years. "Instead, they have spent more than $100 million to open new clinics in suburbs, such as New Berlin, Franklin and Brookfield," according to the report.
The article also discusses how much money hospitals lose from Medicaid reimbursement, which leaves many health systems — either through direct or indirect means — making efforts to limit the number of Medicaid patients they treat, the report states.
A former Milwaukee-area health system executive phrased it this way: "In America, what card I have in my wallet determines my access." When a Medicaid patient is in need of specialty care, especially something for which the market pays a premium: "That's where everybody sort of looks at their shoes," the former health system executive said in the report. "They hope the patient gets care, but they hope somebody else provides it."
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