| CHICAGO, July 31
CHICAGO, July 31 U.S. hospitals are getting a
stronger-than-expected benefit from a new influx of low-income
patients whose bills are paid by the government's Medicaid
program, raising their profit forecasts as a result.
The growing numbers of Medicaid patients helped hospital
operator HCA Holdings Inc, the largest for-profit chain,
post stronger earnings in the second quarter than initially
Notably fewer uninsured patients came through its doors, HCA
said, as millions of Americans signed up for private health
insurance under President Barack Obama's healthcare law. But a
second, unexpectedly strong boost came from a surge in Medicaid
enrollment, which is expanding under the law known as Obamacare.
"In general, Medicaid is the real driver of increases in
insured populations," said Snow Capital Management analyst
The administration says 6.7 million people have signed up
for Medicaid and other healthcare programs for the poor since
Obamacare enrollment began last October.
For HCA, the Medicaid boost was greatest in states that
chose to expand eligibility for coverage, with federal support,
under the Affordable Care Act. HCA said its Medicaid admissions
jumped 32 percent year to date in four expansion states where it
has facilities, and uninsured patient volumes dropped 48 percent
in that time.
Yet even in states such as Texas that oppose Obamacare and
opted not to expand Medicaid eligibility, HCA said it treated
more patients who were enrolled in the program.
"It is interesting to note that uninsured volume from
non-expansion states has also declined," HCA Chief Financial
Officer William Rutherford said on the company's earnings call.
Smaller hospital operator Universal Health Services
also singled out growth at its Texas hospitals, saying it had
not anticipated a big impact from health reform in the state.
"The pleasant surprise of 2014 has really been the
performance of our Texas markets," Universal Chief Financial
Officer Steve Filton said. He said the improving economy in the
state likely played a role.
Some analysts believe non-expansion states are seeing
Medicaid enrollment rise because people who were eligible all
along but had never signed up became aware of their options with
the recent media attention to Obamacare.
"These people are coming out of the woodwork," Bemer said.
An analysis by consultancy Avalere Health found that 17 of
the 26 U.S. states that did not expand Medicaid in the first
three months of the year still reported growth in enrollment,
some by as much as 10 percent.
The impact of higher Medicaid enrollment accelerated in the
second quarter, HCA said. Medicaid admissions were up 7.8
percent compared with a year ago, after rising 1.4 percent in
the first quarter. Self-pay and charity admissions fell 14.7
percent in the second quarter from a year ago.
Hospitals for years have struggled with rising bad-debt
expenses as the uninsured sought treatment in emergency rooms
where they could not be denied care for lack of ability to pay.
"Reform is helping the hospitals cover bad debts," said UBS
analyst A.J. Rice.
An improving U.S. economy is also giving hospitals a boost
as more people schedule procedures after postponing seeking care
during the downturn. HCA said specialties such as orthopedics,
cardiovascular and neuroscience all saw solid growth in the
A further benefit to hospitals is likely to come in the
second half of the year as patients with private insurance who
have met their deductibles schedule medical visits they will not
have to pay for out of pocket.
Private hospitals could also see a bump in business from
U.S. veterans, under a plan being hammered out in Congress, to
address the needs of those unable to get prompt appointments at
Veterans Affairs facilities.
Many expect the positive picture for hospitals to continue
for the foreseeable future. HCA, Universal Health and LifePoint
Hospitals Inc all raised their earnings forecasts for
the full year.
"HCA is well positioned to benefit from a multi-year
favorable backdrop being driven by health reform, an improving
economy and potentially the new VA reform bill," Rice said.
(Reporting by Susan Kelly in Chicago; Editing by Michele
Gershberg and Tom Brown)