February 7, 2011

Mirroring Nation, CT Medicaid Admissions Up

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Connecticut’s hospitals, like the nation, are seeing more beds filled with Medicaid patients, placing “financial stress’’ on facilities.

From 2001 to 2010 there was a 48.6 percent rise in Medicaid hospital admissions in Connecticut, according to figures from the Connecticut Hospital Association (CHA).

Nationally hospital stays covered by Medicaid increased by 30 percent from 1997 to 2008, according to a report released last week by the federal Agency for Healthcare Research and Quality.  The study found a 27 percent increase in uninsured stays and only a 5 percent increase in privately insured stays during the same time period. 

Connecticut’s numbers mirrored the national report, increasing 29.7 percent during AHRQ’s reporting period.

But the AHRQ study’s cut off date did not capture the full effect of the economic downturn, according to CHA spokesperson Patricia Charvat.

“It is causing severe financial stress for hospitals, which only get paid 70 cents on the dollar for care of Medicaid patients,” Charvat said.

Hartford Hospital and its affiliates have been admitting more Medicaid patients, according to Chief Operating Officer Jeff Flaks. That change springs partly from a bad economy but is also “a function of a deliberate effort to help create better enrollment for people in our community who are eligible,” he said.

Medicaid covered 20.7 percent of Hartford Hospital’s patients in calendar year 2010, compared with 18.9 percent in fiscal year 2005, according to figures provided by the hospital.

In the same period, the hospital brought down its rate of uninsured patients to .6 percent from 1.5 percent. The percentage of privately insured patients dropped from 40.5 percent in fiscal year 2005 to 37.2 percent in 2010.

Flaks said that his hospital has looked to contain spending through efficiencies; such has hiring hospitalists, primary care doctors who coordinate care during a hospital stay and can guard against unnecessary costs, such as duplicated tests.

Connecticut hospitals on average improved their profit margins in fiscal 2009, a September 2010 report by the state Office of Health Care Access found, with three quarters of the institutions operating in the black for the year.  Connecticut hospitals reported that 13 percent of their gross revenue came from Medicaid, with non-government payers accounting for 40 percent. Though hospitals improved on the revenue side, the report noted, many lost assets because their endowments and pension funds declined in value.

Nationally, about half of all stays covered by Medicaid were for pregnancy, childbirth and newborn infants, according to AHRQ.  Among privately insured patients, these accounted for only 33 percent of admissions.  Two mental health conditions ranked among the top 10 most frequent reasons for Medicaid hospitalizations: mood disorders and schizophrenia and other psychotic disorders. Mood disorders were common among privately insured patients, schizophrenia was not.

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