The strain on urban trauma centers to treat gunshot wounds could be made worse by Medicaid funding cuts, a new study warns.
Researchers at Northwestern Medicine and the University of Michigan analyzed emergency department and inpatient visits for firearm injuries between 2016 and 2021.
The average annual costs held steady at around $1.2 billion through 2019. But pandemic-era surges in violence caused the costs to jump to $1.6 billion in 2021 — a 33% increase from 2019, researchers found in the study published on Sept. 26 in the JAMA Health Forum.
The total cost of initial treatment for gunshot wounds from 2016 to 2021 totaled $7.7 billion. Of that, over half was billed to Medicaid, researchers determined.
Despite that dependency on Medicaid, reimbursements from the federal health care program often fall short of covering the actual treatment costs, the researchers point out in their study.
That leaves the safety-net hospitals “on the front lines of the gun violence epidemic to absorb substantial losses,” according to a news release from Northwestern Medicine.
“Gun injuries are a source of financial strain on hospitals, particularly large safety-net trauma center hospitals that often operate on thin margins,” Alexander Lundberg, emergency medicine professor at Northwestern University Feinberg School of Medicine and corresponding author of the study, said in the release.
Breaking it down
The largest share of costs went toward treating patients who were Black, male and from low-income areas, according to the press release. The researchers analyzed hospital records from six states: Arkansas, Florida, Maryland, Massachusetts, New York and Wisconsin.
Researchers also note that their findings likely underestimate the total financial toll of firearm injuries because they only include the initial hospital stay or emergency visit. That leaves out the costs for the ambulance, rehabilitation and follow-up visits.
The annual cost of treatment for pediatric patients also grew 54% from 2019 to 2021, according to the study, showing how more and more children are being victimized by shootings.
“In addition to the overall price tag of hospital care for firearm injury, we found that $684 million of those costs were for patients younger than 18 years old,” Regina Royan, first study author and assistant professor of emergency medicine and neurology at the University of Michigan, said in the release.
The study’s authors point out that the recent congressional cuts to Medicaid will only cause more trouble for trauma centers, especially those caring for low-income patients.
“Medicaid funding cuts could further financially destabilize trauma centers,” Anne Stey, a study co-author and a Northwestern Medicine trauma surgeon, said in the release. “Some could close, or stop being trauma centers that provide the high-level and life-saving trauma care that all American families need after car accidents, falls and bike accidents.”
Story ideas
Reporters looking to cover the extensive impacts of Medicaid cuts can learn from this study.
For example, look at the trauma centers in your coverage area: Were they already struggling before the pandemic surge in gun violence and the more recent cuts to Medicaid? What populations are they serving?
Another idea is to look at your state’s data on Medicaid and Medicare reimbursements by hospital and determine which trauma centers depend on federal funding the most. Talk to the hospital’s management, staff and patients. What impacts are they worried about? How do they plan on surviving?
Finally, a future story idea could be to determine how many trauma centers end up closing or losing their level one designation because of cuts to Medicaid. How is the community impacted by that?
