Surveys Show Benefits Of Obamacare For Individuals And Hospitals

Two polls were released today regarding opinion of the effects of the Affordable Care Act, one from consumers and one from hospital administrators. The first is reported by CNN:

More than half the public says Obamacare has helped either their families or others across the country, although less than one in five Americans say they have personally benefited from the health care law, according to a new national poll.

A CNN/ORC International survey also indicates that a majority of Americans oppose the Affordable Care Act, but that some of that opposition is from people who don’t think the measure goes far enough…

According to the poll, only 18% of the public say they or their families are better off now that the major provisions of the health care law have been implemented. Another 35% report that, while their lives have not improved, the Affordable Care Act has benefited other people in the U.S. Add those two numbers together, and that means 53% say that Obamacare has helped either their families or others across the country.

Forty-four percent tell us that the health care law has not helped anyone in the country.

Any poll regarding whether the law has helped people has to be interpreted cautiously. First there are those who follow the Republican line and deny benefits which have been well-documented, such as an increase in the number of insured. Even those answering with an open mind might not realize ways in which they are benefiting.  Before the Affordable Care Act came into effect many people often did not realize the problems in the old system as they had not encountered them personally. In the past I often saw patients with very limited coverage who had no idea how limited their coverage was. Some policies would only cover inpatient or outpatient services. Some policies had severe limitations on how many office calls they would cover or how much they would pay for lab per year. I have seen patients with newly diagnosed diabetes who suddenly needed far more services than in the past but found that they had used up their coverage for the year by around March. Many people also do not realize the risk they previously faced of being dropped by their insurance plan should they develop expensive medical problems. Insurance companies can no longer drop people for medical problems or deny coverage for pre-existing conditions, along with being required to provide comprehensive coverage, including preventative care.

FierceHealthCare reported on a survey of hospital executives which showed that average inpatient admissions were increased by 0.4 percent in the second quarter of this year, following several years of deceases, as a consequence of the Affordable Care Act and other factors. They also found that “The ACA has made a positve impact on hospital performance, according to the survey, with hospitals in states that expanded Medicaid under the healthcare law expressing significantly more positive views about improvements in payer mix and diversity in the second half of the year.”

Hospital inpatient volumes trended positive for the first time in several years–albeit by only a slight margin–according to a new survey from Jefferies. The investment bank and securities firm also released data about hospital performance and payer mix.

Inpatient volume has trended negative for the last few years, due largely to the economic downturn and plan design changes, but average inpatient admissions were up 0.4 percent in the second quarter of 2014, according to the survey results. Researchers attribute the uptick to a combination of the improving economy, the implementation of the Affordable Care Act and patients waiting as long as possible for procedures, compounding demand.

Polling on provider optimism was also positive, according to the survey. Of the executives from 50 hospitals Jefferies polled, seven in 10 expected inpatient volume to be either flat or up in the third quarter, which is remarkable considering the multiyear trend of negative volumes, according to the survey results. Executives at hospitals with more than 250 beds were particularly optimistic, with all such respondents expecting volume increases in the third quarter.

The ACA has made a positve impact on hospital performance, according to the survey, with hospitals in states that expanded Medicaid under the healthcare law expressing significantly more positive views about improvements in payer mix and diversity in the second half of the year.

“That said, 54 percent of our surveyed hospitals indicated that the ACA has not impacted volume trends yet; it is worth noting though that half of hospitals with 500 or more beds noted improved admission trends as a result of the ACA,” the results stated. Jefferies will continue monitoring developments in states that have not yet expanded the program but are “key for the publicly traded hospitals,” including Tennessee, Pennsylvania and Florida.

Thirty-four percent of respondents overall said emergency department (ED) admissions had increased, but the numbers were higher in expansion states (42 percent) than non-expansion states (29 percent). This lines up with the results of a study which found Medicaid expansion in Oregon increased ED volumes, FierceHealthcare previously reported.

The benefits for hospitals in this survey was consistent with previous reports that Medicaid expansion has led to both increased care for the poor and improved revenues for hospitals. The same post also reported on a recent survey conducted by the American College of Emergency Physicians which found that 37 percent of ER physicians reported that patient volume had increased slightly, 9 percent reported that it had increased greatly, and 27 percent reported that the number of ER visits had remained the same.

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