Medicaid expansion alone isn't going to bolster finances or care quality at critical access hospitals, according to a new study.
Research published this week in Health Affairs noted that expanded Medicaid has been a contributing factor to improved financial health for hospitals. However, in a nationwide analysis, the researchers found no evidence that critical access hospitals in expansion states saw statistically significant improvements in margins, staffing or quality compared to those in non-expansion states.
The study included 1,158 such facilities, with 648 in expansion states and 510 in non-expansion states.
It didn't find a significant difference for the hospitals in expansion states on the share of Medicaid inpatient days or reductions in uncompensated care. It also didn't find a significant increase in operating margins.
Critical access hospitals in expansion states also did not show a significant difference in the number of employed physicians or nurses, the study found.
The findings suggest that while Medicaid expansion can be a boon for providers operating in rural or underserved areas, it will not address every challenge they face, the researchers said.
"Taken together, these findings support the argument that although Medicaid expansion may have had benefits for some hospitals, it is not a panacea for all of the challenges facing hospitals serving rural and underserved communities," they said.
The study also posits several reasons that Medicaid expansion does not immediately solve all issues at critical access hospitals. For one, reimbursement rates in Medicaid may not be high enough to cover losses from uncompensated care costs, the researchers said.
In addition, cash-strapped critical access hospitals may also face high costs in other areas, such as new technology, that could be offsetting gains associated with Medicaid expansion.