Having more patients insured under Obamacare could be a game changer for hospitals, especially those with major emergency departments, such as Universal Health Service's George Washington University Hospital in the nation's capital.
U.S. hospitals provided more than $41 billion in uncompensated care in 2011, according to the most recent data available from the American Hospital Association. On average, the cost of that bad debt has risen 8 percent annually since 2006.
"The industry in acute care runs between 12 and 20 percent bad debt," said Alan Miller, founder and CEO of Universal Health Services. "As you know, people that present themselves in emergency rooms must be treated, and so many of these people have no coverage."
That trend could change dramatically, with 7 million people expected to gain coverage through the government health exchanges, and millions more in the states participating in Medicaid expansion.
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For Universal Health, which operates nearly 200 behavioral health facilities, the new mandate that mental health coverage be included in plans could also be a positive catalyst. In the past, policies for individuals and small businesses did not have to provide mental coverage, said Miller, speaking from his firm's Horsham Clinic for behavioral health in Ambler, Pa.
Greater access to treatment could make a big difference for the families of young people with mental health issues, according to Miller.
"Very often, symptoms show up in youngsters, and if you have an ability to pay or to be treated when you are young, teenagers, it's very meaningful in terms of their ultimate cure," he said.
The Affordable Care Act also puts pressure on hospitals in terms of government payments. New Medicare rules have tied reimbursement rates to performance and patient outcomes. The sequester has also resulted in cuts for hospitals.
But analysts say millions of newly insured patients should help offset those pressures.
"We think there's about $3.5 billion of incremental revenue opportunity through the health-care reform that should benefit the sector," said analyst Darren Lehrich of Deutsche Bank Securities.
"When you take that revenue and you offset it against some of the Medicare cuts and other things that come down the line, you get a very beneficial margin bump in the industry's profitability," he said.
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