Hospital uncompensated care

Hospitals Dealing With More Self-Pay Patients, Uncompensated Care

Driven by patients’ loss of health insurance, coverage gaps in insurance policies, an increase in high-deductible plans, and the post-COVID changes in Medicaid eligibility, hospitals are encountering growing numbers of uninsured and self-pay patients. In response, they are pursuing ways to improve billing and bill collection while seeking upfront payments from patients with questionable or no coverage, employing patient navigators, and using AI technology. Learn more about the recent increase in self-pay and uninsured patients and how hospitals are responding to this challenge from the Modern Healthcare article “How hospitals are tackling the surge of self-pay patients” (subscription required).

joe2025-11-10T13:13:18-05:00November 11, 2025|hospitals, Medicaid|

Potential Medicaid Implications of the “One Big Beautiful Act”

Growing uncompensated care. Service cuts. Reduced access to care, especially in rural areas. Expansion projects placed on hold. These are among the potential implications of the Medicaid cuts included in the recently passed FY 2025 budget reconciliation bill, often referred to as the “One Big Beautiful Act.” A significant portion of those cuts will come through limits on state directed payments: supplemental Medicaid payments proposed by the states and approved by the federal government to selected providers for high-cost, high-demand, low-payment services delivered through Medicaid managed care plans. The new law limits future use of this mechanism and may, in [...]

joe2025-08-12T16:55:13-04:00August 13, 2025|hospitals, Medicaid, Medicaid managed care|

If ACA Funding for Medicaid Expansion Were to be Cut…

When Congress enacted the Affordable Care Act in 2010 it offered states a powerful incentive to expand their criteria for Medicaid eligibility: money to pay for most of that expansion. Under that law, the federal government pays 90 percent of the cost of providing Medicaid-covered services to individuals who became eligible for the program under the expanded criteria. So far, 41 states and the District of Columbia have taken advantage of this enhanced funding and 11 million additional people have enrolled in the Medicaid program as a result. But what would happen if that enhanced federal Medical Assistance percentage – [...]

joe2025-03-13T17:26:22-04:00March 17, 2025|Affordable Care Act, hospitals, Medicaid, Medicaid disproportionate share, Medicaid DSH|

Millions Could Lose Medicaid Coverage When COVID Crisis Ends

As many as 15 million Americans may be at risk of losing their health insurance when the COVID-19 public health emergency officially ends, according to a new Urban Institute report. When the COVID crisis began and people began losing their jobs – and with them, their health insurance – Congress increased funding to states for Medicaid under the condition that states not perform eligibility reviews on their Medicaid rolls under after the crisis ends. Since then, Medicaid enrollment has risen nearly 20 percent, and now, that 20 percent – and more – may be in jeopardy of losing their Medicaid [...]

iqtsupport2022-02-07T06:00:26-05:00February 7, 2022|COVID-19, Medicaid|

Supreme Court Paves Way for Public Charge Regulation

The revised public charge regulation that will make it more difficult for some immigrants to come to the U.S. will be implemented after the Supreme Court lifted preliminary injunctions issued by lower courts that delayed the regulation’s implementation. Under revisions of the public charge regulation introduced last year, individuals seeking entry into the U.S. and green cards who do not appear to be financially independent or have employment commitments can be denied entry if they will be dependent on means-tested public aid programs such as Medicaid or food stamps or even if they, or members of their family, appear likely [...]

iqtsupport2020-02-24T10:38:18-05:00February 24, 2020|hospitals, Medicaid|

Supreme Court Lifts Public Charge Rule Ban

The U.S. can now reject visa and green card applicants based on their financial prospects after a new Supreme Court ruling this week. This ruling has potential long-term implications for health care providers. Last August a new Department of Homeland Security regulation took effect that authorized the federal government to reject immigrants’ applications for visas and green cards if their financial situation and employment prospects suggested that they might become a “public charge” and dependent on government safety-net programs like Medicaid and food stamps. A number of groups sued to prevent the rule’s implementation and federal courts imposed an injunction [...]

iqtsupport2020-01-30T06:00:23-05:00January 30, 2020|hospitals, Medicaid|

MACPAC Looks at Medicaid DSH

At a time when cuts in Medicaid disproportionate share hospital payments (Medicaid DSH) are still scheduled for the current fiscal year and some in Congress are calling for a new approach to allotting DSH funds among the states, the Medicaid and CHIP Payment and Access Commission has released its annual analysis of Medicaid DSH allotments to the states. The report includes: data about changes in the uninsured rate demographic information about the uninsured information about the cost of hospital uncompensated care perspectives on hospital Medicaid shortfalls a comparison of hospital uncompensated care costs when calculated using different methodologies data about [...]

iqtsupport2019-11-08T06:00:27-05:00November 8, 2019|hospitals, MACPAC, Medicaid disproportionate share, Medicaid DSH, Medicaid DSH allotments|

New Public Charge Rule Could Affect Immigrants, Providers

Legal immigrants may become reluctant to seek government-sponsored health care and providers may find themselves delivering more uncompensated care in the wake of the adoption of a new federal “public charge” regulation that seeks to define more narrowly the kinds of individuals who should be granted entry to the U.S. in the future. The new Department of Homeland Security regulation, while focused on applicants for entry into the U.S., could have the unintended effect of discouraging legal immigrants from enrolling in Medicaid, CHIP, and other government programs and even lead them to disenroll from such programs out of a mistaken [...]

iqtsupport2019-08-14T09:26:39-04:00August 14, 2019|Uncategorized|

Hospital Uncompensated Care Unchanged in 2017

Despite a modest increase in the uninsured rate, hospital uncompensated care in 2017 was $38.4 billion, essentially the same as it was in 2016 and down from the all-time high of $46.8 billion in 2013. This comes from an American Hospital Association survey that also found that in 2017, hospital admissions and inpatient days rose modestly hospital outpatient visits and surgeries increased emergency room visits declined the proportion of for-profit hospitals declined the number of rural hospitals fell Learn more in the Healthcare Dive article “Uncompensated care costs flat in 2017 despite uptick in uninsured.”

iqtsupport2019-01-11T06:00:13-05:00January 11, 2019|hospitals|

Helping Safety-Net Hospitals Help Their Patients

A new report published on the Health Affairs Blog describes the continuing challenges safety-net hospitals face and offers suggestions for helping them meet those challenges. The challenges, according to the report, are the virtual elimination of the Affordable Care Act’s individual health insurance mandate; the continued decline in the amount of Medicare disproportionate share hospital money (Medicare DSH) provided to safety-net hospitals; and hospital closures that shift more of the burden for caring for uninsured patients onto a smaller pool of safety-net hospitals. The result is under-served patients and new financial risks for the hospitals that remain after some safety-net [...]

iqtsupport2018-05-15T06:00:29-04:00May 15, 2018|Affordable Care Act, hospitals, Medicare disproportionate share, Medicare DSH|