The Arkansas Hospital Association reports a sharp drop in uncompensated care thanks to the private option Medicaid expansion, a drop that meant $69 million in savings from what could have been uncompensated care for people without insurance.

A survey by the Association and the Healthcare Financial Management Association compared the first six months of 2014 with 2013 and found a drop in uninsured patients from 9,100 to 4,900, or 46.5 percent. This was from 136,000 hospital admissions. The plan took effect Jan. 1, 2014. The study covered admissions, emergency rooms and outpatient clinics. From a release:

AHA President and CEO Bo Ryall said, “This survey completes a picture showing that the Arkansas Private Option is successfully doing what it was intended to do. Recent reports have documented that Arkansas leads all other states with the sharpest reduction in its uninsured rate among adult residents since the beginning of the year. So, the private option is definitely making healthcare more accessible for the 204,000 Arkansans enrolled in the program.

For the period Jan. 1-June 30, overall inpatient hospital admissions remained relatively stable compared with the same period in 2013, rising less than 1 percent. Within that small overall increase, the number of uninsured hospitalized patients with no source of payment for their health care fell by 46.5 percent in 2014.

Also, fears that the private option would make care so easily accessible that overcrowding in hospital emergency rooms would rise to unprecedented levels have not materialized, the study found. Total visits to emergency rooms increased less than 2 percent between the six-month spans in 2013 and 2014, despite approximately 25,600 patients with new policies purchased through the Health Insurance Marketplace. Hospitals also recorded 36,400 fewer emergency room visits by uninsured patients, a 35.5 percent decline. 

An increase in the number of patients having insurance policies purchased through the Health Insurance Marketplace apparently did drive an overall 5.8 percent jump in total non-urgent hospital outpatient clinic visits. AHA reports that is an indication that more patients began avoiding emergency rooms as a point of entry into the health care system and instead are seeking care in more appropriate settings such as physician offices and hospital outpatient clinics. At the same time, the total number of uninsured patients seen in those clinics also fell 36 percent.

Ryall said the private option had saved many rural hospitals from “buckling” from uncompensated care burdens.


Thank goodness it looks like Tom Cotton is going to be elected to repeal this Obamacare craziness.

p.s. from David Ramsey:


Also worth noting the that the total number of emergency department visits increased 1.8 percent. This is pretty good news because coverage expansions are often associated with a big initial uptick in ER use. From the AHA: “fears that the private option would make care so easily accessible that overcrowding in hospital emergency rooms would rise to unprecedented levels have not materialized, the study found.”

The big declines in uninsured patients (35.5 percent for ER visits, 46.5 percent for hospitalizations) actually represent even larger declines than the previous AHA survey, which covered the first three months of 2014. For comparison, the survey covering just the first quarter found a decline in total ER visits of 2 percent, a decline in uninsured ER visits of 24 percent, and a decline in uninsured hospitalizations of 30 percent. The number of enrollments in the private option has grown throughout the year, presumably contributing to a bigger dent in uninsured patients in the six-month survey versus the three-month survey (and perhaps the small uptick in total ER visits).

This certainly looks like very preliminary good news. That said, as with the last survey, this study should be treated with caution — we don’t have granular data for individual hospitals, we’re relying on de-identified survey results, and not all hospitals in the state responded to the survey (though the AHA said that respondents represent nearly 80 percent of all hospital patient services by revenue and admissions).