Can Safety Net Hospitals Survive ObamaCare?

Approximately 1,500 hospitals nationwide are known as “safety net” providers because they care for a larger portion of uninsured patients than their competitors…

A report released Tuesday by the private consulting firm Alvarez & Marsal warned that the health care law “may actually worsen the status of many safety net hospitals.”

First, the law slows the rate of regularly scheduled pay bumps from the federal government, meant to help hospitals keep pace with growing health care costs…

Safety net hospitals also will bear the brunt of cuts in “disproportionate share payments,” money that the federal government sends hospitals that cover a high level of uninsured patients. These payments, which come from the Medicaid and Medicare programs, will fall by more than $30 billion over the next decade…

Last, the health care law tethers a small portion of hospitals’ Medicare payments to the quality of care they provide and to patient satisfaction rankings. If hospitals don’t hit certain targets, they stand to lose 1 percent of their Medicare income. Safety net hospitals, separate research suggests, may have a tough time hitting the goals, because they tend to receive lower patient satisfaction ratings than competitors who treat fewer uninsured people.

This is all from Sarah Kliff.

Comments (13)

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  1. Devon Herrick says:

    Universal coverage was supposed to alleviate the financial pressure on safety net hospitals by ensuring that everybody has health coverage. If everyone has coverage, hospital Emergency Departments would not be flooded with uninsured patients just needing primary care; and those patients entering the hospital would have health coverage. But, as time goes by, safety net hospitals have come to realize patients with insurance coverage won’t necessarily seek care else care at the safety net hospitals. The only ones that seek care at the older county hospitals may be those who still lack coverage. It’s a dilemma.

  2. C.B. Sutton says:

    I’m surprised there isn’t an ACA provision that penalizes individuals for emergency visits that should be handled with a primary care doctor.

  3. Ronald says:

    Well, assuming everyone has insurance coverage, wouldn’t it make sense for these safety net hospitals to dissipate?

  4. C.B. Sutton says:

    No hospital will be disposable given the expected shortage of health care in the next two decades.

  5. Gabriel Odom says:

    Considering that Safety Net hospitals are the primary source of care for their local indigent population, this new move is appallingly regressive.

  6. Sam says:

    I think this is somewhat alarming, especially if we want accessible health care to all.

  7. Tim says:

    I thought that equal health care access was the main purpose behind the ACA? I don’t think the demise of safety net hospitals will promote that purpose.

  8. Jacob Druisdael says:

    You mean the ACA — is actually reducing the already tiny safety net?

    It would be ironic if it wasn’t so scary.

  9. Allison Howard says:

    This new reform is already killing small businesses, putting hospitals out of business and leaving many many many people without jobs. Safety net hospitals are no different. As the Alvarez & Marsal’s report explained…the ACA is bound to worsen our health care system.

  10. Brian W. says:


    I get your point. However, this is hardly a “new move”. We’ve all seen this coming for the past several years. Now it’s just a reality.

  11. Jenny M. says:

    Can anyone?

  12. Jack says:

    The lower satisfaction rating wasn’t a big surprise.

  13. Bob Hertz says:

    Because the drafters of the ACA did not have the courage to raise income taxes or raise payroll taxes, they had to hunt around for projected ‘savings’.

    They knew full well that even if the ACA was wildly successful, about 20 million American adults would remain uninsured.

    But the safety net hospitals are not aggressive politically nor do they have powerful Congressional protectors.

    So they were offered up as a backhanded way to pretend to finance the ACA.

    I call it repulsive, and I am a Democrat.