Modeling the Impact of American Health Care Act's Medicaid Provisions on Safety-Net Hospitals

Using the company’s proprietary Hospital Finance Simulation Model, the investigators will estimate the financial impact of proposed Medicaid provisions of the American Health Care Act on safety-net hospitals in the United States. The microsimulation model has been used in the past to project the impact of changes in U.S. payment policy on hospitals for the American Hospital Association, the Federation of American Hospitals, the Medicaid and CHIP Payment Access Commission (MACPAC) and the Centers for Medicare and Medicaid Services (CMS). Dr. Dobson and colleagues will estimate the impact of four provisions in the AHCA on safety-net hospitals’ revenues, costs and net income: 1) elimination of the enhanced federal Medicaid matching rate for expansion enrollees; 2) elimination of the Medicaid Disproportionate Share Hospital reductions; 3) establishment of Medicaid per-capita cap limits; and 4) repeal of the hospital presumptive eligibility provisions and 3-month retroactive coverage.

This project will inform policymakers, delivery system leadership, the media, and the public about the financial implications of the House Republican proposals on the financial stability of hospitals and health systems serving the nation’s most vulnerable and low-income patients.