Safety nets thrilled, but ...

Modern Healthcare - - Opinions Letters -

Pri­vate, not-for-profit, ur­ban safety net hos­pi­tals are thrilled with the pas­sage of health­care re­form that will en­able 32 mil­lion Amer­i­cans to join the ranks of the in­sured— thrilled be­cause so many of those 32 mil­lion re­side in the com­mu­ni­ties we serve.

Our plea­sure, though, is tem­pered by our con­cern about how we will be paid for car­ing for th­ese new pa­tients. Roughly 20 mil­lion of the newly in­sured will be en­rolled in Med­i­caid, which re­im­burses hos­pi­tals for less than the cost of the ser­vices they de­liver in most states. More Med­i­caid pa­tients—roughly 40% more—will mean even greater Med­i­caid losses for ur­ban, safety net hos­pi­tals. Mean­while, re­form will re­duce fund­ing for some of the pro­grams that help com­pen­sate high-vol­ume Med­i­caid hos­pi­tals for their sig­nif­i­cant Med­i­caid short­falls.

The new health­care re­form law is a great start, but it is only a start. Pri­vate, not-for­profit, ur­ban safety net hos­pi­tals are about to take on a big­ger role than ever in car­ing for low-in­come res­i­dents of ur­ban Amer­ica, and pol­i­cy­mak­ers in Wash­ing­ton will need to do more to en­sure that we have the re­sources we need to meet this enor­mous chal­lenge.

Ellen Ku­gler Ex­ec­u­tive di­rec­tor Na­tional As­so­ci­a­tion of Ur­ban Hos­pi­tals



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