Research Alert: July 19, 2016

Does ACA Insurance Coverage Expansion Improve the Financial Performance of Rural Hospitals?

The implementation of the Patient Protection and Affordable Care Act (ACA) increased access to health insurance coverage for previously uninsured or under-insured populations. Since rural residents are more likely than urban residents to be uninsured, increased access to health insurance should, in theory, provide a new source of revenue for rural hospitals and, therefore, improve financial performance. To better understand how the ACA's expansion of insurance coverage has affected uncompensated care, unreimbursed cost, and financial performance in rural hospitals, the NC Rural Health Research Program interviewed rural hospital administrators, state hospital associations, and State Offices of Rural Health (SORHs).

We interviewed 21 health care leaders (rural hospital administrators, state hospital associations, and SORHs) from 8 states about perceptions of changes in payer mix; changes in uncompensated care (bad debt and charity care) and unreimbursed cost (shortfalls between the costs of providing services and payments by public programs); and financial performance in their respective hospitals/state.

Contact Information:

Kristie Thompson
North Carolina Rural Health Research and Policy Analysis Center
kweisner@email.unc.edu

Additional Resources of Interest: