Emergency Medicaid Acquisition Through the Affordable Care Act: The Association Between Hospital Enrollment in California and Hospital Revenue

Medical Care
Linda D TranTodd H Wagner

Abstract

Hospital Presumptive Eligibility (HPE) is a national policy stemming from the Affordable Care Act that allows qualified hospitals, working with state officials, to enroll eligible patients for temporary Medicaid coverage. Although all states are required to operate an HPE program, hospital participation is elective and variable. It is unclear which hospitals choose to participate in HPE and how participation affects hospital utilization and revenue. We examined hospital factors associated with HPE participation in the state of California and assessed pre and post changes in hospital revenue and utilization for HPE and non-HPE hospitals. We performed a logistic regression to identify hospital attributes associated with HPE participation. We then used a difference in differences methodology with a hospital fixed effect to test whether HPE enrollment was associated with changes in annual revenues by payer source, uncompensated care costs, outpatient visits, and/or discharges. Three quarters (76%) of qualified hospitals elected to participate in HPE by the end of 2018. Hospitals with 100 or more beds had over 10 times greater odds of participating in HPE compared with smaller hospitals. Hospitals that did not provide outpatient car...Continue Reading

References

Apr 24, 2018·Journal of the American College of Surgeons·Lisa M KnowltonKristan L Staudenmayer
Nov 1, 2018·Health Services Research·Charles CourtemancheIshtiaque Fazlul

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Citations

Mar 31, 2021·The Journal of Trauma and Acute Care Surgery·Joshua D JaramilloLisa Marie Knowlton

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BETA
cesarean section

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ArcMap
Stata

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