Safety net hospital

Safety net hospitals provide care for those who are of low-income, exploitable populations, and uninsured. Safety net hospitals are not defined by its ownership terms; rather they are more devoted to providing the best possible care for those who are barred from health care due to various circumstances. These circumstances are mostly problems with financial payments, insurance plans, or health. As per America’s Health Care Safety Net: Intact But Endangered, safety nets have two characteristics: they maintain an open-door policy for their services, and that most of the patients are uninsured or on Medicaid. Some safety net hospitals even offer high-cost services like burn, trauma, and neonatal treatments. Some also provide training for medical professionals. The Health and Hospital Corporation in NYC, Cook County Health and Hospital System in Chicago, and Parkland Health & Hospital System in Dallas are three of the country’s largest safety net hospitals.

Financial behavior of safety net hospitals

Safety net hospitals often times find themselves in difficult financial positions. This is due to the vulnerable state of the payers. Safety net hospitals have high rates of Medicaid payers and Medicaid is an unreliable form of payment. Also, there is a high rate of patients that do not have insurance and have low income, so that is yet another unreliable form of payment. In 2013, hospitals across the country generated $44.6 billion in uncompensated care costs, which are services that the hospital provides that the patient cannot pay. These hospitals can afford to provide the services that produce these uncompensated costs due to the funding from the federal, state, and local levels of government. Also, there is a complex array of public funding that comes to safety net hospitals mostly through Medicaid Disproportionate Share Hospital Payments, Medicaid Upper Payment Limit Payments, Medicaid DSH Payments, Medicaid Indirect Medical Education Payments, and state/local indigent health programs. These public funds are, for the most part, coming from Medicaid and Medicare, and in 2013, about $30 billion public dollars were used to pay back safety net hospital uncompensated costs.

Obamacare cuts and safety net hospitals

The federal government has been providing funds for safety net hospitals through the Disproportionate Share Hospital (DSH) program. The DSH has already limited the Medicare portion of the program, and plans on limiting the Medicaid portion of the program. Ultimately, gradual cuts will be made, starting in 2017, to cut the DSH in half because of the theory that once people sign up for insurance with the health care law, there will be a much lesser need for safety net hospitals. However, one issue with Obamacare and safety net hospitals arises from the coverage gap for those who have too high of an income to qualify for Medicaid but have too low of an income to afford a private plan. It is even projected that even with the implementation of the health care law in 2016, roughly 27 million people are still expected to be without insurance coverage and find service in safety net hospitals. Another issue revolves around the fact that hospitals are required to provide care for patients in the emergency department, even if the person cannot pay or is an illegal immigrant. A possible solution for the issue with illegal immigrants has been posed that calls for increased access to health insurance for them, by letting them used tax-subsidized online marketplaces to buy insurance plans.

Safety net hospitals and patient experience

In recent years, safety net hospitals have put emphasis on their attempts to increase their patient experience scores. Safety net hospitals developed training classes for customer service that includes employee evaluations as well as employee orientations.

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