Health Insurance Expansion and Rural Hospital Finances: Evaluating the Impact of the Affordable Care Act in California
Abstract/Contents
- Abstract
- The Patient Protection and Affordable Care Act (ACA) extended health insurance coverage to previously uninsured individuals, thereby altering reimbursement patterns at the hospital level. Given the historical financial difficulties of rural hospitals, this paper focuses on the effect of this insurance expansion on hospital inpatient payer mix and financial outcomes in rural settings. Using hospital-level data from 2006-2017, this paper utilizes a fixed effects regression and difference-in-differences study design to determine the effect of the ACA on rural hospital financial performance in California. I find a statistically significant decline in Medicaid payer mix and increase in private payer mix for rural inpatient services after the ACA. I also find significant reductions in Medicaid income per bed and uncompensated care cost, particularly in uninsured rural areas. However, overall profitability improved in rural hospitals after the ACA, suggesting the financial importance of private shares of payer mix to cover losses incurred by increased expenses of Medicaid patients.
Description
| Type of resource | text |
|---|---|
| Date created | May 8, 2019 |
Creators/Contributors
| Author | Serrato, Paul Irvin |
|---|---|
| Degree granting institution | Stanford University, Public Policy Program |
| Advisor | Mark Duggan |
Subjects
| Subject | Affordable Care Act |
|---|---|
| Subject | Medicaid expansion |
| Subject | California |
| Subject | rural hospitals |
| Subject | financial distress |
| Subject | payer mix |
| Subject | Stanford University |
| Subject | Public Policy Program |
| Genre | Thesis |
Bibliographic information
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- User agrees that, where applicable, content will not be used to identify or to otherwise infringe the privacy or confidentiality rights of individuals. Content distributed via the Stanford Digital Repository may be subject to additional license and use restrictions applied by the depositor.
- License
- This work is licensed under a Creative Commons Attribution Non Commercial 3.0 Unported license (CC BY-NC).
Preferred citation
- Preferred Citation
- Serrato, Paul Irvin (2019). Health Insurance Expansion and Rural Hospital Finances: Evaluating the Impact of the Affordable Care Act in California. Stanford Digital Repository. Available at: https://purl.stanford.edu/pt830xd1767
Collection
Stanford University, Public Policy Program, Undergraduate Honors Theses and Practicum Projects
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- Contact
- paulserrato@alumni.stanford.edu
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