Two years ago, the Mayo Clinic recovered from the credit crisis and recession with a tight grip on expenses. Officials expected the system's flat spending would not last. It did not. After modest growth in 2010, Mayo's expenses increased 5.9% last year.
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State budget shortfalls for the coming year total about $47 billion, the smallest aggregate deficit since the Great Recession, a report says.
The Center on Budget and Policy Priorities found deficits in 29 states for the fiscal year ahead and another 10 states reported revenue for the current year fell $3.2 billion short of budget. Gaps are significantly smaller than in recent years. The smaller shortfall is a marked improvement from the $106 billion this year (so far) and $430 million the prior three years, the report said.
Nonetheless, the gap is still large by historical standards, said authors of the report Elizabeth McNichol, Phil Oliff and Nicholas Johnson.
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RAND Corp. recently released one more estimate of health insurance coverage and costs with and without the health reform law mandate that (pretty much) everyone must be insured. About 12.5 million fewer people would be covered minus the requirement, which is being challenged in a case before the U.S. Supreme Court. Those that would be covered would be those eligible for hefty subsidies, RAND said, leaving the federal government tab unchanged despite millions fewer insured.
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My prior blog post looked at results from a recent report on New York hospital financial aid and state support for uncompensated care. Here's another snapshot, this from the first national disclosure of charity care and community benefit expenses:
The median New York hospital reported free and discounted care totaled 0.74% of total expenses for tax year 2009, the most recent year for which figures are available. The median hospital profit margin was 2.76%.
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New reporting rules for hospitals have created unprecedented public access to hospital financial statements and policies. Those rules have targeted information about how hospitals care for patients who cannot afford to pay, for which hospitals may receive tax-funded subsidies or tax breaks.
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A survey of state Medicaid directors found a healthy majority were on budget, thought some states continue to try to restrain spending by the safety-net insurer to address shortfalls.
California sought to require Medicaid copayments, a proposal that died this week (PDF) when federal officials said no. Meanwhile, Washington state health officials have said Medicaid payments would stop for unnecessary emergency room visits. Such dramatic policy proposals underscore the strain on state budgets and Medicaid spending from the slow recovery.
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The week brings yet one more report to underscore ways that healthcare (despite hiring through the recession) is vulnerable to the weak economy.
A report by the Commonwealth Fund surveyed adults about access to healthcare, insurance coverage and income during the second year after the Great Recession ended.
Responses, taken from more than 2,000 adults, found households living closer to poverty were less likely to be insured. And insurance made a significant difference in whether adults reported receiving basic health screening, such as cholesterol checks or mammograms. That's according to Sara Collins, vice president for affordable insurance at the Commonwealth Fund, who walked me through the maze of statistics that parsed answers by income and insurance coverage.
The recession that began in late 2007 eroded household income and access to healthcare. Unemployment climbed through the recession and has yielded little until recent months. Households abruptly delayed medical care, helping to slow the nation's health spending growth to historical lows. Median income during the first year after the recession was down more sharply after the Great Recession than each of the six prior recessions. Here's a comparison:
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Demand for elective procedures, slowed by the recession and persistently high unemployment, continues to drag along with U.S. job growth, my colleague Jaimy Lee reports this week.
Surgeries to repair worn hips and knees have slumped in recent years as patients delay medical care to avoid the expense or time off from work. The slowdown contributed to the lackluster growth (compared with historical growth rates) for U.S. health spending overall for 2010 and the prior year.
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