Uncompensated care, or expenses not paid out-of-pocket, for the nearly 77 million Americans without insurance during all or part of this year could total up to $57 billion, according to an analysis expected to be published online Aug. 25 by the journal Health Affairs. The government subsidizes as much as three-quarters of uncompensated care, or $42.9 billion, researchers wrote. Physicians underwrite another $7.8 billion by donating time and lost profits, and hospitals absorb $6.3 billion of the unfunded expenses. Cost shifting by providers to offset care for the uninsured probably has only a very small impact on private insurance premiums, at most 1.7% of private insurance costs, the authors wrote. The analysis suggests hospitals do not raise prices for private insurers to offset uncompensated care, which has been a relatively stable 6% of hospital costs for many years, despite a steady increase in the percentage of people uninsured. Insurance coverage for those without would increase healthcare spending by $122.6 billion. Even those with insurance are struggling to pay for care (See story, p. 8).
People are increasingly relying on the Internet to seek information about personal health concerns, according to a national study released by the Center for Studying Health System Change. In 2007, 56% of American adults, or more than 122 million people, sought health information from a source other than their doctor, up from 38% or 72 million people, in 2001, the study found. The proportion of Americans using the Internet as an information source, however, grew the most rapidly compared with other sources, doubling from 16% in 2001 to 32% in 2007. Consumers use of the Internet for health information is now on par with their use of the more traditional, long-standing sources of books, magazines and newspapers (33%), and friends or relatives (31%), which also increased significantly since 2001, the study said. The proportion of seniors using the Internet to get health information increased from 7% in 2001 to 18% in 2007. Growth in the Internet also was reflected in this years choices for the 100 Most Powerful People in Healthcare (See story, p. 6).
Operating performance and liquidity of not-for-profit hospitals remained stable in 2007, but industry pressures first seen two years ago are expected to continue given the nations weaker economy, according to a Moodys Investors Service report on not-for-profit healthcare medians. The median operating margin dropped to 2.1% in 2007 from 2.3% in 2006, and the median operating cash flow margin declined to 9% from 9.2% in the same period. From an operating perspective, margins have come down in the last couple of years, but are still above lows seen in the years after passage of the Balanced Budget Act of 1997, said Mark Pascaris, assistant vice president and analyst at Moodys. The medians are based on an analysis of audited fiscal 2007 financial statements for 410 free-standing hospitals and single-state healthcare systems and 16 multistate healthcare systems.
HHS proposed stronger job protections for doctors and other healthcare workers who refuse to participate in abortions because of religious or moral objections. This proposed regulation is about the legal right of a healthcare professional to practice according to their conscience, HHS Secretary Mike Leavitt said in a written statement. Congress over the past 30 years had enacted several statutes to safeguard freedoms known as provider-conscience rights. In addition to raising awareness of these laws, HHS proposed regulation would require as many as 584,000 employers ranging from major hospitals to doctors offices and nursing homes to certify in writing that they are complying with several federal laws that protect the conscience rights of healthcare workers. Violations could lead to a loss of government funding and legal action to recoup federal money already paid.
A hospital in Tennessee filed for bankruptcy and one in Los Angeles said it plans to. Trinity Hospital, Erin, Tenn., owned by for-profit Associated Healthcare Systems, filed for federal bankruptcy protection and has lined up a buyer willing to pay $2.9 million for the 25-bed hospital, court records indicated. In its bankruptcy petition, Trinity reported both assets and liabilities of between $1 million and $10 million. One filing indicates that Trinity owes $4.1 million to its main bank. The hospital identified the buyer as Patients Choice Medical Center, Erin, a company set up by Ray Shoemaker, according to a court filing. Shoemaker owns and is the president and chief executive officer of Rural Healthcare Developers, a Plantersville, Miss.-based company providing management services to Trinity Hospital. Meanwhile, Century City Doctors Hospital in Los Angeles said it will file for Chapter 7 bankruptcy and close its doors on Aug. 29. Financial difficulties related to the hospitals inability to sell, obtain new financing, or receive extensions or renewals of existing financing, led to the filing, according to a statement from the hospital on Aug. 22, the same day the hospital closed its emergency department and canceled all elective surgeries. Century City, which opened in 2006, soon will begin transferring all patients who cannot be discharged to other area hospitals.
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