Safety-Net Providers in a Post-Reform World:Medicaid Matters
Julia ParadiseAssociate Director
Kaiser Commission on Medicaid and the Uninsured
for
Health Policy, Law, and Ethics ForumGeorge Washington University School of Public Health and Health Services
Wake Forest University School of Law and Center for Bioethics, Health and Society
October 17, 2012
FIGURE 2
The majority of health center and public hospital patients are uninsured people and Medicaid beneficiaries
SOURCE: Public hospital data from America’s Safety Net Hospitals and Health Systems 2010: Results of the Annual NAPH Hospital Characteristics Survey, National Association of Public Hospitals and Health Systems, May 2012. Health center data from 2010 UDS, HRSA.
Health center patients Public hospital discharges
38%18%
39%
36%
14%
19%
8%
25%
3% 3%Other
Medicare
Private
Medicaid/Other Pub-lic
Uninsured
Distribution by payer source:
FIGURE 1
FIGURE 3
Medicaid is a major source of financing for safety-net providers
Private27%
Medicare21%
Uninsured4% Other
3%
Medicaid35%
State/Local Subsidies11%
Total = $47 billion
SOURCE: Public hospital data from America’s Safety Net Hospitals and Health Systems 2010: Results of the Annual NAPH Hospital Characteristics Survey, National Association of Public Hospitals and Health Systems, May 2012. Health center data from 2010 Uniform Data System (UDS), HRSA.
Medicaid38%
State/Local/ Other15%Private
7%Medicare
6%
Federal Grants23%
Self-Pay9%
Other Public3%
Chart Title
Total = $12.7 billion
Public Hospital Net Revenues by Payer, 2010
Health Center Revenues by Source, 2010
FIGURE 2
FIGURE 4
Key Medicaid decisions will affect what safety-net providers can achieve under health reform
Implementation of Medicaid expansion?
Scope of Medicaid benchmark benefits
Medicaid outreach and enrollment
effort
Allocation, targeting of Medicaid DSH
Adequacy of Medicaid provider
payment rates
SAFETY-NETPROVIDERS
FIGURE 3