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Uncompensated care costs increase 25% since 2000
U.S. hospitals provided $28.8 billion in uncompensated care in 2005, up from $26.9 billion in 2004, according to the latest American Hospital Association Annual Survey of Hospitals.
The survey measure includes charity care and bad debt, valued at the cost to the hospital of the services provided. The amount of uncompensated care provided by hospitals has increased by $5.3 billion, or more than 25%, since 2000.
Medicare and Medicaid payments to hospitals continue to fall below their costs of providing those services. According to the survey, Medicare and Medicaid underpaid hospitals by $15.5 billion and $9.8 billion, respectively, in 2005, up from $1.4 billion and $2.6 billion in 2000.
Nearly two-thirds of hospitals received Medicare payments less than cost, while more than three-quarters received Medicaid payment less than cost.
Barriers to EHR use described in study
Financial, technical, and legal barriers are keeping many physicians and hospitals from adopting electronic health records (EHRs), according to a study published online by Health Affairs (www.healthaffairs.org).
The authors, from Massachusetts General Hospital and George Washington University, found insufficient data to determine hospital adoption trends, but said best estimates indicate only 5% of U.S. hospitals have implemented computerized physician order entry, the best indicator in existing surveys for EHR use.
The report, funded by the Robert Wood Johnson Foundation and National Coordinator for Health Information Technology, found only one in four physicians use EHRs. The authors said improved definitions for EHR and "adoption" are needed to better measure adoption trends.
CDHPs reduce care use; It's not clear if they deter it
Consumer-directed health plans can reduce health care use and lower costs, but it's not known whether these high-deductible plans also will deter people from getting needed care, according to a recent study by RAND Corp.
"The evidence from early adopters of these plans and similar changes in health insurance shows that greater cost sharing leads to reductions in health care use and expenditures," says lead author Melinda Beeuwkes Buntin.
"We know people are going to reduce their use of health care under these plans," she adds. "But what we don't know is how this will affect overall health care quality and patients' health."
RAND plans to address that and related questions as part of a four-year, $4 million study co-sponsored by the California HealthCare Foundation and Robert Wood Johnson Foundation.
U.S. hospitals provided $28.8 billion in uncompensated care in 2005, up from $26.9 billion in 2004.Subscribe Now for Access
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