As ranks of uninsured and underinsured swell, the state’s four major health systems have seen their uncompensated care — charity care plus unpaid bills — more than triple in nine years, to $698 million in 2012.
Nonprofit Intermountain Healthcare alone forgave more than half a billion dollars in charges. So at what point do hospitals insist that Utah expand Medicaid to cover more of the state’s uninsured?
Utah leaders are undecided about whether to stretch Medicaid in 2014 to cover an estimated 58,000 uninsured adults.
The federal government will pick up the entire bill for new enrollees the first three years, and at least 90 percent of the expenses after that, totaling $4.1 billion between 2014 and 2019.
But the state’s portion is considerable and predicted to mount to $174 million by 2020, and possible more if the deficit forces Congress to trim entitlement spending.
Lawmakers, industry leaders and advocates are awaiting the unveiling of a state-commissioned cost study by Public Consulting Group, which has been delayed twice.
The economics of a Medicaid expansion make it a no-brainer, consumer advocates argue.
Federal Medicaid dollars generate rounds of spending as hospitals staff up and invest in equipment upgrades, and as health care workers spend their earnings on restaurants and cars.
Hospital executives agree that covering the uninsured is a good for public health and their bottom lines. The most recent earnings forecast for HCA, owner of Utah’s for-profit MountainStar Hospitals, fell short of analysts’ expectations as revenue gains were overshadowed by unpaid patient bills.
On a national level, HCA supports expanding Medicaid.
But Utah’s uninsured rate isn’t as high as in other states, "which is why we are working with other health care providers [to find] … solutions that help in the short term and are sustainable in the long run," said MountainStar spokeswoman Audrey Glasby.
Unpaid care at University Hospitals and Clinics has grown from 6 percent to 8 percent of the budget in recent years, said CFO Gordon Crabtree. The system doled out $39 million in financial aid in fiscal 2011-12 and wrote off $59 million in bad debt.
To compensate, the university has cut about 300 staff through attrition over the past three years and squeezed drug and device makers for better prices. Salt Lake Tribune
