The uproar in Minnesota and Congress caused by an inquiry into Accretive Health's business practices apparently did not totally unnerve the company's first and largest customer.
Ascension Health, the nation's largest not-for-profit health system, accounted for nearly 41% of Accretive's revenue at the end of March. Ascension Health also owns 7% of the Chicago-based billing and collection company.
Accretive—which settled a lawsuit last week with Minnesota's attorney general by promising to stay out of the state for two years—disclosed in a filing with the Securities and Exchange Commission that Ascension has renewed its contract for another five years.
Accretive admitted no wrongdoing and continued to reject allegations that it violated patient privacy, debt collection and consumer protection laws.
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The healthcare reform law's Medicaid expansion would provide coverage to roughly 11.5 million adults who live below the poverty line but are currently ineligible for the safety-net insurance, the Urban Institute estimates. But should states choose not to expand Medicaid, those adults would be left out of the reform law's push to reduce the number of uninsured.
With income below the poverty line, they would be paradoxically too poor to qualify for subsidies under the law to buy commercial health plans. Those subsidies are available for those with income above the poverty line up to 400% of that threshold. (Not everyone will be able to hold on to subsidized insurance as income fluctuates with a change in jobs or hourly work schedules.)
For hospitals, fewer insured would undermine one proposed benefit of the Patient Protection and Affordable Care Act: fewer unpaid medical bills.
Here's a look at the states, ranked by the number of adults who are currently ineligible for Medicaid yet living below the poverty line, as estimated by the Urban Institute's Health Policy Center.
Source: Urban Institute
*Urban Institute researchers advise caution for Vermont's estimate of <1, which has a standard error of more than 30%.
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As has been reported here previously, the cost of healthcare regularly creates financial stress for U.S. households. The Great Recession made matters more difficult. Even with insurance coverage, falling ill frequently means trouble with medical bills and debt.
For hospitals, that translates to write-offs for patients who cannot pay. Healthcare executives, analysts and actuaries have also said a noticeable slowdown in healthcare spending that accompanied the weak economy suggests that households may be delaying medical care.
Delays appear to be widespread among older adults who lack insurance. That's according to a new analysis of access to care and financial distress among adults age 55 and older. The Henry J. Kaiser Family Foundation analyzed survey data from the Center for Studying Health System Change for adults ages 55 to 64 and seniors covered by Medicare.
The analysis, published in a recent report, compared survey responses for uninsured and privately insured older adults too young for Medicare. Adults were asked if they had unmet medical needs, delayed seeking care, had difficulty paying for prescriptions or if their household struggled with medical bills.
Unsurprisingly, uninsured older adults were more likely to report access and financial problems. Nearly all uninsured adults who struggled with access said the reason was cost.
Here's a look at comparisons:
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