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HOSPITALS: How many DSH hospitals are there?

Hospitals that serve a higher proportion of low-income patients are eligible to receive disproportionate share payments from state Medicaid programs.

DSH hospital: A hospital that receives disproportionate share hospital (DSH) payments and meets the minimum statutory requirements to be eligible for DSH payments: a Medicaid inpatient utilization rate of at least 1 percent and at least two obstetricians with staff privileges that treat Medicaid enrollees (with certain exceptions” (page 57)

In this report from the Medicaid and CHIP Payment and Access Commission (MACPAC), there is a table that quantifies the number of disproportionate share hospitals (DSH) in the United States as of 2012.

DSH Hospitals: Counts by Type of Hospital

  • 1,865 (55 percent) of Short-term acute care hospitals
  •    565 (42 percent) of Critical access hospitals
  •    129 (26 percent) of Psychiatric hospitals
  •      47 (58 percent) of Children’s hospitals
  •      32 (  7 percent) of Long-term hospitals
  •      32 (13 percent) of Rehabilitation hospitals

Counts by Location

  • 1,681 (40 percent) of urban hospitals
  •    989 (54 percent) of rural hospitals

Counts by Teaching Status

  • 1,921 (39 percent) of non-teaching hospitals
  •    392 (59 percent) of “low-teaching” hospitals
  •    357 (79 percent) of “high-teaching” hospitals

Source: Medicaid and CHIP Payment and Access Commission. (2017, March). Report to Congress on Medicaid and CHIP (pp. 57, 59). Washington, D.C.: MACPAC.  Click here for access: https://www.macpac.gov/wp-content/uploads/2017/03/March-2017-Report-to-Congress-on-Medicaid-and-CHIP.pdf  Posted by AHA Resource Center (312) 422-2050, rc@aha.org

 

30 Largest Accountable Care Organizations

SK&A has released an updated ranking of the largest accountable care organizations based on the number of participating physicians. The marketing contacts firm has identified 703 ACOs involving 479,000 healthcare providers and business personnel aligned with ACOs. Topping its published list of the 30 largest ACOs are:

  1. HealthCare First South Los Angeles, a Medicaid ACO with 7,237 participating physicians and 2,668 health facilities
  2. Heritage Provider Network & Anthem Blue Cross of California, a commercial ACO with 7,207 physicians and 4,177 facilities
  3. Heritage California ACO, a Medicare Shared Savings Program with 6,876 physicians and 3,905 facilities
  4. Tenet Healthcare & Humana, a commercial ACO with 6,644 physicians and 1,963 facilities
  5. Hill Physicians/Dignity Health/University of California, San Francisco & Health Net, a commerical ACO with 5,883 physicians and 2,118 facilities

Source: Top 30 accountable care organizations. SK&A, Feb. 2017. http://www.skainfo.com/reports/top-accountable-care-organizations [free registration required to view/download]

Posted by AHA Resource Center, (312) 422-2050, rc@aha.org

UNINSURED: 48.3 million in 2010 dropped to 28.7 million in 2015 (U.S. national data for non-elderly population)

In 1972, the earliest year shown in this source, there were 30.7 million Americans under age 65 who did not have health insurance.  This number has varied somewhat from year to year – sometimes dropping, sometimes rising – but reached the highest number (48.3 million) in 2010.  In 2015, the number of uninsured Americans under 65 who were uninsured dropped to 28.7 million.  Here are some of the years shown in this source:

Number of Persons Uninsured (under 65 years old)

  • 30.7 million  1972 (the earliest year)
  • 23.0 million  1978 (the lowest year)
  • 48.3 million  2010 (the highest year)
  • 28.7 million  2015 (the most recent year)

Source: U.S. National Center for Health Statistics. (2017, February). National Health Interview Survey: Long-term trends in health insurance coverage. Click here: https://www.cdc.gov/nchs/data/nhis/earlyrelease/trendshealthinsurance1968_2015.pdf   Posted by AHA Resource Center (312) 422-2050, rc@aha.org

Health Innovations State Law Database

The Health Innovations State Law Database created by the National Conference on State Legislatures is  a resource for identifying over 800 recently enacted state laws and regulations that address health policy innovations related to access, Medicaid, private and commercial insurance markets, the Accountable Care Act and social determinants of health.. The database supports searching by keyword, state, legislative status, bill number, sponsor, and/or these topics:

  • Exchanges and Health Marketplaces
  • Free Market; Challenges and Alternatives
  • Market-Cost Containment
  • Market-Coverage
  • Market-Delivery Reform [includes accountable care]
  • Market-Health Insurance Reforms
  • Market-Mandates and Essential Health Benefits
  • Market-Network Adequacy
  • Market-Other
  • Market-Payment Reforms
  • Market-Price Transparency
  • Medicaid Expansion and Waivers
  • Medicaid Payment Reform
  • Medicaid-General
  • PPACA – ACA-Health Reforms
  • State-Run Programs
  • Telehealth Programs

However, the full-text of the legislation located is restricted to NCLS members.

Source: Health innovations state law database: tracking state laws for health care transformation, 2015-2016. National Conference of State Legislatures, accessed Jan. 27, 2017. http://www.ncsl.org/research/health/health-innovations-database.aspx

Posted by AHA Resource Center, (312) 422-2050, rc@aha.org

Medicaid and CHIP Data: Findings from a 50-State Survey

The Kaiser Family Foundation has just released its 15th annual 50-state survey on Medicaid and the Children’s Health Insurance Program [CHIP].

The report provides and discusses state data on eligibility, enrollment, renewal and cost-sharing policies and identifies changes over the past year. It also documents the key health coverage role the Medicaid and CHIP programs play for low-income families.

As health coverage policy direction gets debated, this report will provide helpful background information.

Source: Brooks T and others. Medicaid and CHIP eligibility, enrollment, renewal, and cost-sharing policies as of January 2017; findings from a 50-state survey. Kaiser Family Foundation, Jan. 2017. http://files.kff.org/attachment/Report-Medicaid-and-CHIP-Eligibility-as-of-Jan-2017

Related:

Rosenbaum S and others. Medicaid’s future: what might ACA repeal mean? Commonwealth Fund Issue Brief, Jan. 2017. http://www.commonwealthfund.org/publications/issue-briefs/2017/jan/medicaids-future-aca-repeal

State health facts: Medicaid and CHIP. Kaiser Family Foundation, accessed Jan. 12, 2017 at http://kff.org/state-category/medicaid-chip/

State Medicaid fact sheets. Kaiser Family Foundation, Jan. 26, 2017. http://kff.org/interactive/medicaid-state-fact-sheets/?utm_campaign=KFF-2017-January-Medicaid-State-Fact-Sheets

Blumberg LJ and others. Implications of partial repeal of the ACA through reconciliation. Urban Institute, Dec. 2016. http://www.urban.org/sites/default/files/publication/86236/2001013-the-implications-of-partial-repeal-of-the-aca-through-reconciliation_0.pdf

Cunningham P and others. Understanding Medicaid hospital payments and the impact of recent policy changes. Kaiser Commission on Medicaid and the Uninsured Issue Brief, June 2016. http://files.kff.org/attachment/issue-brief-understanding-medicaid-hospital-payments-and-the-impact-of-recent-policy-changes

Guy J and others. Repeal of the ACA Medicaid expansion: critical questions for states. State Health Reform Assistance Network, Robert Wood Johnson Foundation Issue Brief, Dec. 2016. http://statenetwork.org/wp-content/uploads/2016/12/State-Network-Manatt-Repeal-of-the-ACA-Medicaid-Expansion-Critical-Questions-for-States-December-2016.pdf

Posted by AHA Resource Center (312) 422-2050 rc@aha.org

MEDICARE: CMS fast facts provides US national statistics

This is a nice two-page summary of current statistics related to the Medicare and Medicaid programs. It provides official federal government counts of people and money – the number of beneficiaries and persons served and a recap of national health expenditures.  But WAIT!  There’s more!  I am excited to let you know of a count of the total number of providers by type in the U.S.  How many total hospitals?  How many hospitals of different types?  How many skilled nursing facilities?  Ambulatory surgery centers?  Labs?  And other types of providers.  These are useful totals for business planners who are sizing the market for a new product, for example.

Source:

U.S. Centers for Medicare & Medicaid Services. (2016, July 7). Fast Facts.  Click here for free full text: https://www.cms.gov/fastfacts/

For more indepth information: https://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/CMS-Fast-Facts/  Posted by AHA Resource Center (312) 422-2050, rc@aha.org

 

TRENDS: Enrollment in employer-sponsored health insurance declining

In 2015, 48 percent of employees in the private sector were enrolled in employer-sponsored health insurance, according to data from the federal government’s Medical Expenditure Panel Survey (MEPS).  This percentage has been dropping in a straight-line fashion since 2008 (the earliest year in this data source), when 54 percent were enrolled.  Not surprisingly, the data show that employees in large firms are much more likely to be enrolled in employer-sponsored health insurance than those in small firms.  However, regardless of the size of the firm, the data from 2008 to 2015 show a decrease.

What do I like about this article? 

  • Authoritative government agency data source (MEPS is a survey conducted by the Agency for Healthcare Research and Quality – AHRQ)
  • Free full text document
  • Data plus narrative explanation of trends

Source: Miller, G.W., Vistnes, J., and Keenan, P. (2016, July). Results from the 2015 MEPS-IC private-sector national tables. Statistical Brief, 492, 5.  Click here for free full text:  https://meps.ahrq.gov/data_files/publications/st492/stat492.pdf  Posted by AHA Resource Center (312) 422-2050, rc@aha.org