Hospitals Worry About Underpayments as Medicaid Expands in PA
The Healthy Pennsylvania Medicaid expansion will bring Medicaid payments that often fall below hospital costs, potentially causing problems for hospitals that serve especially large numbers of new Medicaid beneficiaries.
While hospitals acknowledge that in some cases they will, under the program, start receiving payments for care they otherwise might have provided without any reimbursement at all, they note that the payments they expect from Healthy PA private insurers will fail to cover the cost of the care they provide in many cases.
The problem is especially acute when it comes to payment for outpatient services, which may cover only about 30 percent of the cost of outpatient care.
Because they serve so many Medicaid patients, this situation is likely to pose an especially great challenge for Pennsylvania’s safety-net hospitals.
For a look at the challenges hospitals expect under the Healthy PA Medicaid expansion and the effect it may have on their bottom line, see this Pittsburgh Tribune-Review story.