Slammed, Slammed and Slammed Again
Many providers are telling us their cash situations are getting very tight. Below are reasons that is occurring and will continue to occur. Give us a call if we can be of any help.
~ Jack Fischer
Uncompensated Care Contributing to Negative Margins for Public Hospitals and Healthcare Systems
The number of U.S. public hospitals and health systems that have negative margins is rising dramatically, according to a membership survey by the National Association of Public Hospitals and Health Systems.
In 2000, almost half of the survey respondents experienced negative margins, up from less than one-third in 1995. In 2000, respondents had a negative margin of 1 percent, on average.
Medicare, Medicaid and state or local governments pay for almost 80 percent of the services provided by the respondents. The respondents reported that between 1999 and 2000, their losses for the direct costs of treating Medicaid patients rose by 68 percent, with an average cost-to-payment ratio of only 0.74.
Losses from Medicare are also increasing. In 2000, respondents lost more than $420 million on services to Medicare patients, more than double the loss they incurred just one year earlier in 1999.
Medicaid, Medicaid disproportionate share hospital, and independent Medicare education payments covered only 37 percent of uncompensated costs in 2000, down from 43 percent in 1999.
Numbers of Americans With and Without Insurance Rise, Census Bureau Reports
The number of people with health insurance rose by 1.2 million between 2000 and 2001, to 240.9 million, but at the same time the number of uninsured rose by 1.4 million, to 41.2 million, the Commerce Department's Census Bureau reported recently.
Meanwhile, an estimated 14.6 percent of the population had no health insurance coverage during all of 2001, up from 14.2 percent in 2000.
"The percentage of people covered by employment-based health insurance dropped a point, to 62.6 percent in 2001," said Robert Mills, author of Health Insurance Coverage: 2001 . "That was the principal cause of the overall decrease in health insurance coverage."
Mills said the increase in the number of people who were insured could be attributed to overall population growth.
The number (8.5 million) and proportion (11.7 percent) of uninsured children did not change significantly.
Other highlights:
- The number and percentage of people covered by government health insurance programs rose significantly between 2000 and 2001. This resulted largely from an increase in the number (from 29.5 million to 31.6 million) and percentage (from 10.6 percent to 11.2 percent) of people covered by Medicaid.
- Although Medicaid insured 13.3 million poor people, another 10.1 million poor people had no health insurance in 2001. They represented 30.7 percent of the poor, unchanged from 2000.
- Young adults (18-to-24 years old) remained the least likely of any age group to have health insurance in 2001. Nearly 72 percent of this age group had coverage.
- Based on three-year averages, the proportion of people without health insurance ranged from around 7.2 percent in Rhode Island and Minnesota to around 23.2 percent in New Mexico and Texas. Based on two-year moving averages, the proportion of people without coverage fell in 14 states and rose in nine between 2000 and 2001.
- Compared with 2000, the proportion of people who had employment-based policies in their own name fell for workers employed by firms with fewer than 25 employees, but was unchanged for those employed by larger firms.
200,000 Medicare Beneficiaries will Lose HMO Coverage in 2003
Medicare HMO’s will drop coverage for 200,000 elderly and disabled Americans next year. That will bring to 2.4 million the number of beneficiaries who have been dropped by HMO’s since 1998.
This data comes from the American Association of Health Plans (AAHP) member survey. September 09, 2002 was the deadline for HMO’s to inform the government of their plans to participate in the Medicare program in 2003.
Approximately 5 million people, or about 12.5 percent of the roughly 40 million Medicare beneficiaries, are in HMO’s. The number of people who will be dropped by HMO’s in 2003 is smaller than then number dropped in any of the last four years.
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