Teaching Hospitals’ Share of Care for Uninsured Growing, Commonwealth Fund Study Finds
A new Commonwealth Fund report has found that teaching hospitals are at particular risk if uninsured volumes are not reduced. The report, "A Shared Responsibility: Academic Health Centers and the Provision of Care to the Poor and Uninsured," concludes that providing uncompensated care "is having a significant impact on the bottom line of" academic health centers. Between 1991 and 1996, the percentage of charity care provided by such centers grew from 20.4% to 27.9%, the report says, while the average margins of hospitals with "higher" charity caseloads decreased between 1994 and 1996, the report says. David Blumenthal, executive director of the Commonwealth Fund Task Force on Academic Health Centers, said, "If the number of uninsured increases, many community-based providers may have to consider limiting their own commitment to absorbing the financial losses of caring for uninsured and low-income patients. Teaching hospitals don't have that option. They are committed to maintaining their social missions of research, medical education and providing care to the poor and uninsured." In order to lessen the effect of the "growing number of uninsured" on AHCs' ability to provide charity care, the report recommends:
- Expanding CHIP and Medicaid programs
- Altering Medicare and Medicaid disproportionate share payment regulations to direct funds to "institutions most involved in providing care to the poor and uninsured"
- Increasing federal support for studies on improving care for the uninsured, and
- Seeing that medical students receive "appropriate training and experience" in caring for the poor, the uninsured and racial and ethnic minorities (Commonwealth Fund release, 4/18).
