Modern Healthcare - - LATE NEWS -

The num­ber of unin­sured non-el­derly adults has dropped by more than 10 mil­lion since the launch of the Oba­macare ex­changes last year, ac­cord­ing to the Ur­ban In­sti­tute’s Health Re­form Mon­i­tor­ing Survey. The unin­sured rate na­tion­wide was 12.4% in Septem­ber 2014, down from 17.5% a year ear­lier. The Ur­ban In­sti­tute’s data are sim­i­lar to other re­ports show­ing a sig­nif­i­cant drop in the unin­sured rate since the full im­ple­men­ta­tion of the Pa­tient Pro­tec­tion and Af­ford­able Care Act. In states that ex­panded Med­i­caid, the unin­sured rate dropped from 15% to 10.2%, while the rate has dropped from 20.1% to 15.1% in non-ex­pan­sion states.

Health­care em­ploy­ers added 28,900 jobs last month to bring the sec­tor’s em­ploy­ment to 14.9 mil­lion work­ers, the lat­est fed­eral data show. Ro­bust growth in am­bu­la­tory care was largely re­spon­si­ble for the gains. Novem­ber’s job growth was above the year’s monthly av­er­age of 23,550 jobs. Hir­ing this year has re­bounded after a slow­down last year, which was most pro­nounced among hos­pi­tals, the in­dus­try’s largest sec­tor. In the 12 months that ended in Novem­ber, health­care em­ploy­ers added 261,200 jobs for growth of 1.8%. That was dur­ing the first year of in­surance ex­pan­sion un­der the Pa­tient Pro­tec­tion and Af­ford­able Care Act. The newly in­sured are ex­pected to fuel ac­cel­er­ated health­care spend­ing after sev­eral years of his­tor­i­cally slow growth (see story, p. 11).

The out­look for U.S. not-for-profit health­care providers re­mains neg­a­tive for the year ahead, with smaller hos­pi­tals likely to bear the brunt of the fi­nan­cial pain, ac­cord­ing to the lat­est anal­y­sis from Moody’s In­vestors Ser­vice. Pres­sure on topline rev­enue growth, a re­sult of a shift­ing payer mix and pa­tient vol­umes, plus in­vest­ments in physi­cian prac­tices and in­for­ma­tion tech­nol­ogy will con­tinue to squeeze mar­gins in the next 12 months, Moody’s pre­dicts. One of the main driv­ers be­hind the an­a­lysts’ fore­cast is the ex­pec­ta­tion that op­er­at­ing cash-flow growth will be slow. Me­dian es­ti­mates range from -0.5% to 1.5%, far be­low the 7% growth in cash flows reached in 2009.

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