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Will increased revenue at for-profit hospitals lead more states to expand Medicaid?

About Joseph Burns

Joseph Burns (@jburns18), a Massachusetts-based independent journalist, is AHCJ’s topic leader on health reform. He welcomes questions and suggestions and tip sheets at joseph@healthjournalism.org.

Photo by Jonathan Haeber via Flickr

Photo by Jonathan Haeber via Flickr

Will large hospital systems start to pressure officials in the states that have not expanded Medicaid now that their revenues have increased more than expected in the 26 states that expanded Medicaid under the Affordable Care Act?

That question seems obvious given the results of a new report (pdf) by PwC’s Health Research Institute that showed increased revenue among the nation’s five largest for-profit hospital chains in Medicaid expansion states. The PwC report shows that in states that expanded Medicaid, the five for-profit chains—Community Health Systems (CHS), HCA Holdings, LifePoint Hospitals, Tenet Healthcare and Universal Health Services (UHS)—had more insured and fewer uninsured patients in the first half of this year than they did in the first half of 2013. Hospitals in non-expansion states experienced the opposite, the consultants said. These chains run 538 hospitals in 35 states.

PwC analyzed quarterly earnings reports filed with the SEC, industry surveys and conducted interviews with hospital executives to report that the five hospital chains saw Medicaid admissions rise 10.4 percent to 32 percent since Jan. 1. At the same time, all five hospital chains reported that admissions among self-paying patients declined sharply in all states as well. Self-paying admissions dropped by 14.7 percent at CHS, by 6.6 percent at HCS, by 30.3 percent at LifePoint, by 6.5 percent at Tenet and by 9.3 percent at UHS, the report showed.

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