Safety-net hospitals play a critical role in providing care to vulnerable populations, especially at a time when employer-sponsored coverage has declined and the demand for safety-net services has gone up.
While the Patient Protection and Affordable Care Act (PPACA) creates some opportunities for safety-net providers, it also presents significant challenges. Medicaid is the single largest revenue source for most safety-net hospitals. Under PPACA, approximately 16 million additional people are anticipated to enroll in the Medicaid program. But many states are cutting Medicaid rates paid to hospitals and other providers in order to balance their budgets. Additionally, under the health reform law, the Department of Health and Human Services is to develop a new method to reduce disproportionate share hospital (DSH) payments, another stream of funding which safety-net hospitals have counted on.
Who does the safety-net system currently serve and how will this patient mix change as the health reform law plays out? How are safety-net hospitals faring in the current economic environment and how are they altering the way they provide care? How are states and safety-net systems planning for the challenges and opportunities presented under PPACA when its major provisions become effective, starting in 2014 ? What are some policy options for sustaining financial viability of safety-net hospitals in the short-term and long-term?
To answer these important questions and related ones, the Alliance for Health Reform and The Commonwealth Fund sponsored a June 4 briefing. Speakers were: Patrick Conway, Centers for Medicare and Medicaid Services; Billy Millwee, Texas Medicaid Director; Arthur Gianelli, NuHealth System, Nassau County, NY; and Deborah Bachrach, Manatt, Phelps & Phillips. Ed Howard of the Alliance and Pamela Riley of Commonwealth co-moderated.
Full Transcript (Adobe Acrobat PDF)