Callison Kevin, Walker Brigham, Stoecker Charles, Self Jeral, Diana Mark L
Kevin Callison (
Brigham Walker is a research assistant professor in the Department of Health Policy and Management, Tulane School of Public Health and Tropical Medicine.
Health Aff (Millwood). 2021 Mar;40(3):529-535. doi: 10.1377/hlthaff.2020.01677.
We examined changes in hospital uncompensated care costs in the context of Louisiana's Medicaid expansion. Louisiana remains the only state in the Deep South to have expanded Medicaid under the Affordable Care Act and can serve as a model for states that have not adopted expansion, many of which are located in the South census region. We found that Medicaid expansion was associated with a 33 percent reduction in the share of total operating expenses attributable to uncompensated care costs for general medical and surgical hospitals in Louisiana in the first three years after expansion. Reductions varied by hospital type, with larger effects found for rural and public hospitals versus urban and for-profit or private nonprofit hospitals. As hospital operating expenses consistently increased during the sample period, our results imply that hospitals in Louisiana are treating fewer patients for whom no reimbursement was provided since the state expanded Medicaid.
我们研究了路易斯安那州医疗补助扩大背景下医院未补偿医疗费用的变化情况。路易斯安那州仍是美国南部腹地唯一依据《平价医疗法案》扩大医疗补助的州，可为尚未实施医疗补助扩大的州提供范例，其中许多州位于南部人口普查区。我们发现，在医疗补助扩大后的头三年里，路易斯安那州综合内科及外科医院的未补偿医疗费用在总运营费用中所占份额下降了33%。费用降幅因医院类型而异，农村和公立医院的降幅大于城市及营利性或私立非营利性医院。鉴于样本期内医院运营费用持续增加，我们的研究结果表明，自该州扩大医疗补助以来，路易斯安那州医院收治的无报销患者数量有所减少。
