Missouri Health

JEFFERSON CITY, Mo. — A new report from the Missouri Hospital Association found that in 2011, Missouri hospitals provided $1.1 billion in uncompensated care to Missourians — a record level. The report underscores the central role hospitals play in supporting Missourians’ health and the economic health of communities throughout the state.

“In 2011, hospitals provided 22 percent more charity care than in 2010,” said Herb B. Kuhn, MHA president and CEO. “For the first time in the state’s history, charity care and bad debt exceeded $1 billion. Since our first report in 2004, charity care has increased 404 percent.”

The report found that the 129 participating hospitals provided $622.8 million in charity care in 2011. Hospitals’ total uncompensated care is comprised of both charity care and bad debt. When they are added together, hospitals reported $1.1 billion in uncompensated care.

“This year’s report demonstrates hospitals’ ongoing commitment to delivering care to members of their communities who are unable to pay. However, it also signals the need for a better system — one that ensures Missourians have expanded access to insurance. Extending health insurance to additional Missourians would help these individuals manage their health more effectively, provide increased access to services in the most appropriate venue and reduce the cost of health care for all Missourians,” Kuhn said.

The Affordable Care Act cuts hospital payments to Missouri hospitals by $3.3 billion from 2013 to 2020. However, these cuts are partially offset by the act’s expansion of Medicaid and premium support for the uninsured to purchase health insurance on a health insurance exchange. If fully implemented, these changes would significantly reduce the cost of the uninsured in Missouri. If Missouri does not expand the state’s Medicaid program as outlined in the ACA, many of Missouri’s poorest residents will remain uninsured, and these costs will continue to be borne by hospitals, taxpayers and those with commercial insurance.

“Absorbing more than $1 billion in uncompensated care annually while facing $3.3 billion in cuts creates an unsustainable situation for hospitals,” Kuhn said. “These new numbers bring even more urgency to the Missouri debate about expanding coverage for the uninsured. Without the offsetting revenue that comes from newly insured individuals, Missourians’ access to high quality and affordable care is in jeopardy.”

There are additional benefits provided to the communities served by hospitals. Medicare and Medicaid programs often pay less than the cost of providing care. In 2011, hospitals absorbed $1.7 billion in the unpaid costs of treating these beneficiaries.

In addition, hospitals’ community benefit investments are often driven by defined areas of local need. In 2011, hospitals donated $36 million to causes in their community and $33 million to free or reduced costs for medical clinical services. Hospitals also contributed $287 million to the education of health professionals to build and sustain the health care workforce.

“Hospitals are important community institutions. They not only provide important health services, but they also strengthen the economic health of the areas they serve,” Kuhn said. “Hospitals are a leading employer statewide, and in many communities — urban, suburban and rural — they are the top employer. Hospitals’ investments in people and infrastructure add significant value to Missouri’s economy.”

The report found that in 2011, participating hospitals employed 142,123 individuals in 119,843 full‐time equivalent positions. The salary and benefits of these individuals totaled $8.4 billion in 2011. Hospitals’ $1.4 billion investment in 2011 for facilities and equipment added to the economic impact. These investments underpin Missouri’s economy, providing support for families and businesses throughout the state.

“Hospitals provide life‐saving care and community‐supporting jobs and investments,” Kuhn said. “The 2012 Community Investment Report demonstrates why hospitals are essential to the state and communities throughout Missouri.”

A recently released report from University of Missouri underscores the economic value of expanding coverage for Missourians.

“Policymakers face a unique opportunity to create more than 20,000 jobs and bring about important improvements in our state’s health care system,” Kuhn said. “By adopting the Medicaid expansion, policymakers can begin to address the unsustainable costs of the uninsured while building Missouri’s economy.”

The Missouri Hospital Association is a not‐for‐profit association in Jefferson City that represents 154 Missouri hospitals. In addition to representation and advocacy on behalf of its members, the association offers continuing education programs on current health topics and seeks to educate the public about health care issues.

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Hospital‐specific data on community benefit and economic impact is available online.