19 emergency departments honored for leadership, quality

https://www.beckershospitalreview.com/rankings-and-ratings/19-emergency-departments-honored-for-leadership-quality.html

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The Emergency Nurses Association recognized 19 emergency departments across the U.S. with its Lantern Award, which honors EDs that demonstrate excellent performance in leadership, practice, education, advocacy and research.

The award is named in honor of Florence Nightingale, referred to as the “Lady of the Lamp” for carrying a lantern as she cared for wounded soldiers in the night during the Crimean War.

“The Lantern Award acts as a visible symbol to patients that the receiving emergency department values excellence and delivers exceptional care,” said ENA President Jeff Solheim, MSN, RN. “It shines a light on that emergency department’s commitment to providing safe practice and safe care.”

Here are the 19 Lantern Award recipients for 2018:

1. AtlantiCare Regional Medical Center — Hammonton (N.J.) Satellite Emergency Department
2. Belton (Mo.) Regional Medical Center Emergency Department — HCA Midwest Health System
3. Bethesda Butler Hospital Emergency Department — TriHealth (Hamilton, Ohio)
4. Bon Secours St. Mary’s Hospital Pediatric Emergency Department (Richmond, Va.)
5. Boston Children’s Hospital Emergency Department
6. Hughes Spalding Hospital Emergency Department — Children’s Healthcare of Atlanta
7. Inova Loudoun Emergency Department (Leesburg, Va.)
8. Inspira Medical Center Elmer (N.J.) Emergency Department
9. Marin General Hospital Emergency Department (Greenbrae, Calif.)
10. Morristown (N.J.) Medical Center Emergency Department — Atlantic Health System
11. Northwestern Medicine Central DuPage Hospital Emergency Department (Winfield, Ill.)
12. Pennsylvania Hospital Emergency Department — Penn Medicine (Philadelphia)
13. Sarasota (Fla.) Memorial Health Care System Emergency Department
14. St. Anthony Hospital Emergency Department (Lakewood, Colo.)
15. Suburban Hospital Emergency Department — Johns Hopkins Medicine (Bethesda, Md.)
16. Swedish Medical Center Emergency Department — HCA-HealthONE (Englewood, Colo.)
17. The Reading Hospital Emergency Department — Tower Health System (West Reading, Pa.)
18. UCLA Medical Center Emergency Department (Los Angeles)
19. UPMC Pinnacle Hanover Hospital Emergency Department (Hanover, Pa.)

 

 

Governor says hospital tax could cover Medicaid expansion

https://www.charlotteobserver.com/news/article214337194.html

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Maine’s Republican governor is publicly laying out a proposed tax hike on hospitals to pay for voter-approved Medicaid expansion.

Gov. Paul LePage’s office says Medicaid expansion will offset a tax hike by decreasing charity care and bad debt. Maine’s hospital tax rate is 2.23 percent, and Rabinowitz said Maine could go up to six percent.

Maine Hospital Association lobbyist Jeffrey Austin previously told The Associated Press that Maine hospitals pay $100 million in annual taxes and would oppose an increase.

Mainers voted last fall to expand Medicaid to 80,000 low-income adults.

LePage’s administration is fighting litigation by advocates calling on the governor to stop blocking expansion. LePage vetoed legislation funding Maine’s share of expansion with surplus and tobacco settlement funds after he argued lawmakers must fund expansion without raising taxes.

 

 

Shares of CHS continue to slide

https://www.beckershospitalreview.com/finance/shares-of-chs-continue-to-slide.html

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Shares of Franklin, Tenn.-based Community Health Systems closed July 3 at $3.06, their lowest closing price ever and down 2.2 percent from the day prior.

The 119-hospital chain’s stock price traded as low as $2.82 on July 3 after closing July 2 at $3.13 per share. CHS’ shares have lost 34 percent of their value since hitting $4.64 on June 20, according to Seeking Alpha.

CHS’ share price began sinking June 29 after the company priced a new offering of approximately $1.03 billion of senior secured notes after markets closed June 28. The company intends to use the proceeds to pay off about $1.01 billion in outstanding term loans and related expenses.

 

 

224 hospital benchmarks | 2018

https://www.beckershospitalreview.com/lists/224-hospital-benchmarks-2018.html

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Hospitals across the nation compete in a number of ways, including on quality of care and price, and many use benchmarking to determine the top priorities for improvement. The continuous benchmarking process allows hospital executives to see how their organizations stack up against regional competitors as well as national leaders.

For the seventh year, Becker’s Hospital Review has collected benchmarks related to some of the most important day-to-day areas hospital executives oversee: quality, patient satisfaction, staffing, utilization, finance, affiliations, compensation and health IT.

 

St. Louis hospital offers nurses summers off to retain staff

https://www.beckershospitalreview.com/compensation-issues/st-louis-hospital-offers-nurses-summers-off-to-retain-staff.html

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The pediatric unit at Mercy Children’s Hospital in St. Louis will give nurses summers off work in an effort to retain staff, KMOV reports.

The nurses who choose the seasonal staffing option would still work full-time — three shifts per week for the pediatric unit’s nine-month busy season (September through May). The nurses can take off from June through August, while keeping full-time benefits, and return to their jobs in September.

“It’s exciting to see what the nurses, coming back to the unit after having three months off and doing whatever they want to do, the excitement they are going to have, the rejuvenation for their practice, maybe having a new spark, interest [or] excitement for nursing,” Justin Travis, the nurse manager for pediatrics at Mercy Children’s, told KMOV.

Seasonal staff will receive a stipend every two weeks to cover insurance costs. They also can use accrued paid time off to pay themselves during the summer and work extra hospital shifts as needed, Mr. Travis said.

The hospital is recruiting pediatric nurses for the positions. The contract year would begin in September, meaning the nurses’ first summer off would be next year.

Hospital officials said they may expand seasonal staffing options to other departments if it works in pediatrics

 

Average hourly, annual wages for NPs by state

https://www.beckershospitalreview.com/compensation-issues/average-hourly-annual-wages-for-nps-by-state.html

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California has the highest annual wage for nurse practitioners in the U.S., with Golden State NPs earning $126,770 a year on average, according to the most recent data from the Bureau of Labor Statistics.

Here is the average hourly and annual wage for NPs in each state, listed in alphabetical order.

Alabama
Hourly: $45.62
Annual Wage: $94,880

Alaska
Hourly: $60.16
Annual Wage: $125,140

Arizona
Hourly: $50.47
Annual Wage: $104,970

Arkansas
Hourly: $45.79
Annual Wage: $95,230

California
Hourly: $60.95
Annual Wage: $126,770

Colorado
Hourly: $53.10
Annual Wage: $110,440

Connecticut
Hourly: $56.97
Annual Wage: $118,500

Delaware
Hourly: $50.66
Annual Wage: $105,380

District of Columbia
Hourly: $52.81
Annual Wage: $109,840

Florida
Hourly: $48.04
Annual Wage: $99,930

Georgia
Hourly: $49.95
Annual Wage: $103,890

Hawaii
Hourly: $58.93
Annual Wage: $122,580

Idaho
Hourly: $49.40
Annual Wage: $102,760

Illinois
Hourly: $49.02
Annual Wage: $101,960

Indiana
Hourly: $48.93
Annual Wage: $101,780

Iowa
Hourly: $50.06
Annual Wage: $104,130

Kansas
Hourly: $47.05
Annual Wage: $97,870

Kentucky
Hourly: $45.89
Annual Wage: $95,450

Louisiana
Hourly: $47.49
Annual Wage: $98,780

Maine 
Hourly: $48.13
Annual Wage: $100,100

Maryland
Hourly: $52.81
Annual Wage: $109,840

Massachusetts
Hourly: $57.76
Annual Wage: $120,140

Michigan
Hourly: $49.16
Annual Wage: $102,250

Minnesota
Hourly: $55.84
Annual Wage: $116,150

Mississippi
Hourly: $51.58
Annual Wage: $107,280

Missouri
Hourly: $46.39
Annual Wage: $96,490

Montana
Hourly: $46.86
Annual Wage: $97,470

Nebraska
Hourly: $48.04
Annual Wage: $99,930

Nevada
Hourly: $50.73
Annual Wage: $105,520

New Hampshire
Hourly: $54.06
Annual Wage: $112,440

New Jersey
Hourly: $56.55
Annual Wage: $117,630

New Mexico
Hourly: $52.56
Annual Wage: $109,330

New York
Hourly: $56.35
Annual Wage: $117,210

North Carolina
Hourly: $51.11
Annual Wage: $106,320

North Dakota
Hourly: $49.75
Annual Wage: $103,470

Ohio
Hourly: $48.90
Annual Wage: $101,710

Oklahoma
Hourly: $45.96
Annual Wage: $95,590

Oregon
Hourly: $54.27
Annual Wage: $112,870

Pennsylvania
Hourly: $47.24
Annual Wage: $98,260

Rhode Island
Hourly: $52.23
Annual Wage: $108,630

South Carolina
Hourly: $46.70
Annual Wage: $97,140

South Dakota
Hourly: $48.09
Annual Wage: $100,030

Tennessee
Hourly: $45.18
Annual Wage: $93,970

Texas
Hourly: $53.53
Annual Wage: $111,330

Utah
Hourly: $48.06
Annual Wage: $99,960

Vermont
Hourly: $49.96
Annual Wage: $103,920

Virginia
Hourly: $49.15
Annual Wage: $102,240

West Virginia
Hourly: $45.67
Annual Wage: $95,000

Washington
Hourly: $55.41
Annual Wage: $115,250

Wisconsin
Hourly: $49
Annual Wage: $101,930

Wyoming
Hourly: $54.48
Annual Wage: $113,310

 

 

Hospital bad debt rises in tandem with growing share of patient financial responsibility

http://www.healthcarefinancenews.com/news/hospital-bad-debt-rises-tandem-growing-share-patient-financial-responsibility?mkt_tok=eyJpIjoiTmpWaFpXRXlaRE13TVdOayIsInQiOiI3eUgrK0tQYitiVERnY1RVeGk0enpGRUZDdUJBck44ZTQ0WFhqVFkxZWd2M0krd0JyU1ViQ0JnTk5xd0FkK0tHUXlyaURuaDRwUWJwRlhSTTBpT1lJdTQ5VjRia0VId3dNZ1h6ZWY3UVhSZElQK3RtcmFiUndmbW5ZeGZxUmRUbSJ9

 

The trend even includes Medicare bad debt, which results when hospitals exhaust efforts to collect from beneficiaries and must be paid back.

Hospitals continue to face financial challenges as the landscape shifts, and the challenge posed to hospitals by patient balances after insurance, or PBAI, is growing. That’s according to a new TransUnion Healthcare analysis that showed PBAI rose from 8 percent of the total bill responsibility during the first quarter of 2012 to 12.2 percent during the same quarter in 2017.

Commercially insured patients experienced a PBAI increase of 67 percent from $467 to $781, the analysis showed. The rising trend fueled an 88 percent increase in total hospital revenue attributed to PBAI over the 5-year period.

As patients take on more risk and shoulder more of their own healthcare costs, uncompensated care is also rising. TransUnion cited the American Hospital Association’s 2017 Hospital Fact Sheet, which said uncompensated care increased by $2.6 billion dollars in 2016, the first increase in three years. Rising PBAI has no doubt amplified bad debt for providers, contributing to that rise.

Jonathan Wiik, principal for healthcare strategy at TransUnion, said he expects the figure to have risen in 2017 and again in 2018.

The analysis also indicated that Medicare Bad Debt, which happens when Medicare patients don’t pay their deductibles and coinsurance, rose from $3.14 billion in 2012 to $3.69 billion in 2016, a 17 percent increase. If a hospital feels it has exhausted all efforts to get money from a Medicare beneficiary who has an outstanding copay coinsurance or deductible, and they have documented their efforts to collect, Medicare will actually pay the hospital back though not dollar-for-dollar. Wiik said Medicare pays about 65 cents on the dollar for that payback so the hospital still loses some money, about a third of the bill to be exact.

“A great example of that is a hip surgery patient that has Medicare, has a $1,000 deductible and never paid it,” Wilk said. “The hospital would have gotten $650 back but lost $350.”

The trend indicates that hospitals continue to experience reimbursement pressure that can be tied directly to the increase in how much of their own medical cost patients are now taking on

“That’s a very scary thing. For the average elective surgery the number used to be 10 percent, now it’s 30. Patients are great volume for hospitals but they are horrible payers compared to insurance companies. They cost twice as much to collect from and they take three times as long to pay. That’s an administrative burden for the hospital-cost to collect – it’s significantly higher to collect from a patient than from a insurer,” Wilk said.

To show just how much the payer landscape has shifted for hospitals, patients are now generally ranked as a top tier payer for hospitals, right after Medicare and Medicaid. Then comes PBAI and then commercial, according to Wiik. And with patients in the top of a hospital’s AR ranking, he’s seeing some clinics do deductible holds in which they delay their claim while a related hospital claim processes. They don’t send it in until the patient meets the deductible through the hospital. Once it is met then the clinic will send in their claim and get paid right away because the payer is paying, not the patient.

A big part of the problem is a huge gap in benefits literacy for patients coupled with the driving force of consumerism.

“They don’t understand the magnitude of the costs they they are going to get hit with. A relatively simple elective surgery will blow a $2,500 dollar deductible out of the water almost every time. Patients don’t realize that until it happens so hospitals should be engaging them early and putting patient-facing estimates in front of them. And it’s really not about collecting money from patients anymore it’s about getting them financing,” Wiik said.

That means proactively setting up payment plans to spread debt out over time, which protects not only the patient experience but also the hospital’s revenue. Plus it’s a more pleasant conversation to have. If patients are a higher ranking payer, hospitals should be putting into place more policies to deal with their needs and requirements, treating them like the force they are becoming.

“Imagine if you were going in for knee surgery and your hospital sent you a text that said here’s your payment plan would you like to start that now. I think a lot of patients would appreciate that. It doesn’t happen. But it should. The technology is there. You can buy groceries online now and go pick them up. It’s all billed electronically now.”

It can be hard to do estimates and set up payment plans early because medical costs cost can vary so much, but patients want that kind of experience. They put it on the hospitals to figure out how to get them a bill that is at least close to what they were expecting, and set them up to pay for it.

“They are going to go somewhere where that experience is frictionless. That’s what hospitals have to be aware of,” Wilk said. “The market is highly competitive when it comes to that type of stuff and the ones who are innovating and engaging patients are going to get those millennials and the folks that live paying their bills online.”

 

 

Labor Unions Will Be Smaller After Supreme Court Decision, but Maybe Not Weaker

 

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With the Supreme Court striking down laws that require government workers to pay union fees, one thing is clear: Most public-sector unions in more than 20 states with such laws are going to get smaller and poorer in the coming years.

Though it is difficult to predict with precision, experts and union officials say they could lose 10 percent to one-third of their members, or more, in the states affected, as conservative groups seek to persuade workers to drop out.

The court’s decision is the latest evidence that moves to weaken unions are exacting a major toll. Beyond the dropout campaigns aimed at members, conservatives are bringing lawsuits to retroactively recover fees collected by unions from nonmembers.

In May, President Trump signed three executive orders making it easier to fire government workers and reining in the role of unions representing federal workers.

Dropping out of a union is a more attractive proposition now that workers no longer have to pay a so-called agency fee, typically about 80 percent of union dues, if they choose not to belong to a union. (Those doing so generally account for a small fraction of the workers whom public-sector unions represent.)

In the five years after Michigan passed a law ending mandatory union fees in 2012, the number of active members of the Michigan Education Association dropped by about 25 percent, according to government filings, a much faster attrition rate than before. Its annual receipts fell by more than 10 percent, adjusting for inflation.

Still, the more interesting question is whether the unions, whatever the blow to their ranks and finances, will be substantially weaker.

Union leaders insist that they won’t — that the crisis posed by the case, Janus v. American Federation of State, County and Municipal Employees, has brought more cohesion and energy to their ranks.

“No one wanted this case,” said Randi Weingarten, president of the American Federation of Teachers. “But the gestalt around the country has been to turn an existential threat into an opportunity to engage with our members like never before.”

There are reasons to believe that the claim is not merely desperate bravado.

One parallel to the current development is a 2014 Supreme Court ruling known as Harris v. Quinn, which struck down mandatory union fees for home-based workers who serve private individuals but are paid through government programs like Medicaid.

As of late 2013, the Service Employees International Union represented about 60,000 public-sector home care and child-care workers in Illinois, about 40 percent of whom were union members. (The rest paid agency fees.)

Receipts for the service employees union local representing home-based workers in Illinois dropped significantly in the four years after the decision. But an aggressive membership campaign largely offset the loss of members.

It also built and reinforced personal relationships with members, who could be summoned to make demands of politicians in nearly every legislative district.

“Our members go and meet Sam McCann,” said Keith Kelleher, who until last year was president of the local representing these home-based workers, referring to a Republican state senator. “He says yes most of time because he’s got hundreds of members in his district.”

Public home-based workers in Illinois, a state with a notably anti-union Republican governor, continue to notch victories as a result. Last summer, home care workers won a 48-cent-an-hour wage increase from the state, up from an average wage of $13, in a budget that the legislature passed by overriding the governor’s veto. This spring, home child-care workers won more than a 4 percent raise.

In anticipation of the Janus ruling, major public-sector unions have invested heavily in recent years in reaching out to current members — an effort known as internal organizing — and to prospective members to keep their numbers from dropping precipitously and to create a more activist culture. They plan to continue funding these initiatives even if it requires cutting spending elsewhere.

Mary Kay Henry, the international president of the service employees union, said the union used projections derived from its experience after the Harris decision to cut its budget by 30 percent shortly after Mr. Trump was elected. She said the union, which represents about two million workers, roughly half of them in the public sector, was focusing its spending on recruiting members and mobilizing workers to face down employers and elect pro-labor politicians.

“We intend to prioritize the political and organizing work,” she said.

Government filings show that the union has cut contributions to organizations that it had traditionally supported, including the Children’s Defense Fund, People for the American Way, and the National Immigration Law Center. (The union says it provides nonmonetary support to some of these groups.)

At the same time, the union is investing tens of millions of dollars in a door-to-door canvassing initiative for the midterm elections, intended to turn out people who don’t normally vote.

Lee Saunders, president of the American Federation of State, County and Municipal Employees, said that his union’s two highest priorities going forward would be its internal outreach and helping to organize nonunionized workplaces, and that the union would probably “have to make adjustments” to fund these programs. The union spent more than $15 million during the 2016 campaign cycle supporting political candidates, parties and committees.

Mr. Saunders said the union, which represents over 1.2 million workers, had held one-on-one conversations with nearly 900,000 members since 2013. Among the goals of these conversations, he said, is to inoculate members against campaigns by conservative groups to urge them to quit.

“If someone knocks on their door talking about how you can get out of the union — ‘it would be so easy, you don’t have to pay union dues’ — our folks are prepared to tell them to get the hell off their doorstep,” he said.

Alexander Hertel-Fernandez, a political scientist at Columbia University who studies corporate and conservative efforts to weaken labor, said organized interest groups had traditionally had the greatest impact on elections by educating members about candidates and through on-the-ground canvassing rather than large campaign contributions. “It’s doubly so for unions,” he said, adding that the focus “seems like a wise decision, but the effectiveness has to be weighed against what happens to membership and overall revenues.”

The unions enjoy certain advantages. States like California and New Jersey have tried to ease the blow from Janus pre-emptively by passing legislation that, for example, guarantees public-sector unions access to new hires and their personal contact information to help in recruiting.

There is also a substantial wind at their back: a rising energy on the left during the Trump era. Workers in particular appear more willing to take to the streets and state capitols, including tens of thousands of teachers who walked off their jobs this year in conservative states to protest the underfunding of public education.

When the Supreme Court ruled last month that employment contracts could prohibit workers from bringing class-action lawsuits, activists in states like New York, Vermont and Oregon escalated their efforts to pass so-called private attorneys general legislation, allowing workers to bring cases on the state’s behalf that could benefit all affected workers, the same way litigation by an attorney general would.

“We’ve had many, many folks calling: ‘I heard about this legislation you helped design. How do we make this happen?’” said Deborah Axt, co-executive director of Make the Road New York, an advocacy group pushing the measure. Ms. Axt said the group planned to campaign for the legislation’s enactment this summer.

That kind of energy appears to be benefiting unions. A Gallup poll last summer showed labor’s approval at its highest level since 2003, and unions in West Virginia and several other states where teachers walked off the job this year report gains in members.

“We’ve seen a 13 percent jump in membership because of the walkout,” said Ed Allen, president of the Oklahoma City American Federation of Teachers. “We have over 300 people signed up to work in political campaigns. We’ve never seen those kinds of numbers before.”

 

Microsoft Healthcare is a new effort to push doctors to the cloud

https://www.theverge.com/2018/6/27/17509096/microsoft-healthcare-cloud-systems

Microsoft has been working on health-related initiatives for years, but the company is now bringing its efforts together into a new Microsoft Healthcare team. This doesn’t mean you’ll be visiting a Microsoft Store anytime soon for human virus scans, instead it’s a bigger effort to create cloud-based patient profiles, push doctors to the cloud, and eventually have artificial intelligence analyzing data.

The software maker has hired two industry veterans to help out: Jim Weinstein and Joshua Mandel. Weinstein is the former CEO of the Dartmouth-Hitchcock Health system and joins Microsoft as the VP of Microsoft Healthcare, and will work with healthcare organizations to move systems to the cloud. Mandel joins as Microsoft Healthcare chief architect, after completing a nearly two-year stint at Google as an executive for the company’s Verily venture (formerly Google Life Sciences). Mandel will be working closely with the open standards community to create an open cloud architecture for all healthcare providers.

Microsoft’s new Healthcare team appears to be a more formalized approach to the company’s Healthcare NExT (New Experiences and Technologies) company-wide initiative that kicked off last year. NExT was designed to foster health industry partnerships and bring together Microsoft’s research, AI, and cloud teams to focus on healthcare.

Microsoft is trying to find ways to move healthcare data to the cloud securely and in a way that doesn’t break strict compliance requirements for confidentiality. The new Microsoft Healthcare team will be part of Microsoft’s broader AI and Research division. “At Microsoft, we’re confident that many aspects of the IT foundations for healthcare will move from on-premise doctors’ offices and clinics to live in the cloud,” explains Peter Lee, head of Microsoft Healthcare. “We are taking concrete steps with an initial ‘blueprint’ intended to standardize the process for the compliant, privacy-preserving movement of a patient’s personal health information to the cloud and the automated tracking of its exposure to machine learning and data science.”

Lee admits the company has its “work cut out for us,” and this certainly won’t be an easy task for Microsoft. There’s an ongoing race to bring more technology to healthcare and, in particular, artificial intelligence. IBM, Baidu Google, and Alibaba are all working on similar healthcare initiatives, but IBM has struggled with its own efforts. Some analysts predict that AI use in healthcare will grow over the next decade and potentially generate huge savings for the US healthcare economy. Microsoft is clearly part of the broader race to introduce cloud technology, IoT devices, and AI into healthcare, and this new team will be responsible for that. Microsoft now plans to share more about Microsoft Healthcare later this year.

 

Rising Uninsured Rate Expected to Stress Margins of Nonprofit Providers

https://www.healthleadersmedia.com/finance/rising-uninsured-rate-expected-stress-margins-nonprofit-providersImage result for Uninsured

More than 4 million people have lost coverage in the past two years, including many lower-income adults. That could prove problematic for safety net hospitals in the near future.

The ongoing efforts to destabilize the Affordable Care Act will adversely affect the operating margins of not-for-profit healthcare providers, according to a new analysis from S&P Global.

S&P analyst Allison Bretz said that over time, “a growing uninsured population could be a credit negative for not-for-profit hospitals and health systems, as these facilities would likely see an uptick in self-pay patients, charity care and bad debt.”

Two years into the Trump administration’s efforts to roll back the ACA, the uninsured population has risen from about 12.7% in 2016 to 15.5% in 2018.

A study by The Commonwealth Fund estimates that 4 million people have lost health insurance since 2016, and that the uninsured rate among lower-income adults rose from 21% in 2016 to 25.7% this spring.


“This will be most acute at safety-net providers and other providers with a high concentration of Medicaid patients, as that population is most vulnerable to many of these changes,” Bretz said in remarks accompanying the report.

Beth Feldpush, senior vice president of policy and advocacy for America’s Essential Hospitals, said the report “underscores concerns we’ve had since last year’s attempts to repeal the ACA and, now, with piecemeal changes that have weakened the law.”

“Many of the people who lose coverage seek care at our hospitals, which adds to uncompensated costs and puts more pressure on our members’ already low operating margins,” Feldpush said. “Because essential hospitals, by their mission, turn no one away, this could prove financially unsustainable for some.

Although active efforts to repeal the ACA in Congress have slowed in the past year, it is facing one of its greatest threats, as a federal judge in Texas hears a lawsuit brought by 20 states that challenges the constitutionality of the sweeping healthcare law.

For-profit, Payer Outlook Stable

While the rising uninsured rate could prove challenging for not-for-profit providers, S&P analyst David Peknay said it should have little effect on for-profit providers.

“The for-profit companies we rate have been reporting some increase in uninsured patients, consistent with national trends, but the impact on ratings is also currently immaterial,” he said.

The losses in covered lives for health insurance companies is offset by other factors, said S&P analyst Joseph Marinucci.

“A key contributing factor is the sustained migration of the government-sponsored insurance segments toward coordinated care (Medicare Advantage and managed Medicaid), which is expanding the market opportunity for health insurers,” Marinucci said.

“We expect ratings in the insurance sector to remain relatively stable in the near term despite the growth in the number of working-age uninsured individuals,” he said.