Jul 28, 2026 · 1 hr 1 min · 21 segments
Tuesday, July 28 marks the 700th live edition of the commemorative Talk Ten Tuesdays broadcast. And in honor of this celebration, the ICD10monitor producers of the popular news and information service…
Penny JeffersonHost
Denise BuenningGuest
Tiffany Ferguson
Dennis JonesHost
Tim Powell
Maureen TestoniGuest
Rose DunnGuest
Cheryl Erickson
Christine Geiger
Ronald HirschGuest
Edward M. RocheGuest
Frank Cohen
Matthew AlbrightGuest
Fred StodolakGuest
I'm going to talk about the Medicaid unwinding and how it's a hospital financial problem.
When pandemic-era continuous Medicaid coverage ended in 2023, Every state resumed eligibility redeterminations.
Florida removed approximately 1.3 million people, while Arkansas completed an unusually rapid six-month review that removed more than 427,000 residents.
Some individuals were no longer financially eligible, many lost coverage for procedural reasons, unreturned forms, outdated address, missed notices, incomplete documentation, without a definitive determination that they were ineligible.
For the effective person, this can mean more than simply changing insurance plans.
People who lose Medicaid may delay physician visits, skip prescriptions, and avoid diagnostic testing.
Some transition to employer coverage or an Affordable Care Act plan, but others become uninsured, at least temporarily, and patients frequently do not discover the determination until a hospital, physician, or pharmacy checks their eligibility.
An uninsured patient still arrives in an emergency room, requires inpatient treatment, and needs follow-up care.
What previously generated a Medicaid payment may become charity care or bad debt.
Safety net hospitals, children's hospitals, rural facilities, and hospitals serving communities with high Medicaid enrollment carry a disproportionate share of the burden.
The Medicaid unwinding can also affect Medicare disproportionate share hospital payments.
The Medicare dish calculation includes a Medicaid fraction generally based on inpatient days for patients who are eligible for Medicare but not entitled to Medicare Part A.
When patients lose their Medicaid eligibility, their inpatient days may no longer qualify for the Medicaid fraction.
A declining Medicaid fraction can reduce a hospital's disproportionate share and in some cases threaten to reduce it to zero.
A hospital may serve more uninsured patients and occur more uncompensated care while simultaneously reporting fewer Medicaid eligible days and receiving less dish reimbursement.
Medicare distributes its uncompensated care pool among eligible hospitals using each hospital's relative share of uncompensated care costs primarily derived from the Medicare cost report worksheet S-10.
More uninsured patients can increase a hospital's charity care and bad debt cost reported in SDAN.
I'm going to talk about the Medicaid unwinding and how it's a hospital financial problem.
When pandemic-era continuous Medicaid coverage ended in 2023, Every state resumed eligibility redeterminations.
Florida removed approximately 1.3 million people, while Arkansas completed an unusually rapid six-month review that removed more than 427,000 residents.
Some individuals were no longer financially eligible, many lost coverage for procedural reasons, unreturned forms, outdated address, missed notices, incomplete documentation, without a definitive determination that they were ineligible.
For the effective person, this can mean more than simply changing insurance plans.
People who lose Medicaid may delay physician visits, skip prescriptions, and avoid diagnostic testing.
Some transition to employer coverage or an Affordable Care Act plan, but others become uninsured, at least temporarily, and patients frequently do not discover the determination until a hospital, physician, or pharmacy checks their eligibility.
An uninsured patient still arrives in an emergency room, requires inpatient treatment, and needs follow-up care.
What previously generated a Medicaid payment may become charity care or bad debt.
Safety net hospitals, children's hospitals, rural facilities, and hospitals serving communities with high Medicaid enrollment carry a disproportionate share of the burden.
The Medicaid unwinding can also affect Medicare disproportionate share hospital payments.
The Medicare dish calculation includes a Medicaid fraction generally based on inpatient days for patients who are eligible for Medicare but not entitled to Medicare Part A.
When patients lose their Medicaid eligibility, their inpatient days may no longer qualify for the Medicaid fraction.
A declining Medicaid fraction can reduce a hospital's disproportionate share and in some cases threaten to reduce it to zero.
A hospital may serve more uninsured patients and occur more uncompensated care while simultaneously reporting fewer Medicaid eligible days and receiving less dish reimbursement.
Medicare distributes its uncompensated care pool among eligible hospitals using each hospital's relative share of uncompensated care costs primarily derived from the Medicare cost report worksheet S-10.
More uninsured patients can increase a hospital's charity care and bad debt cost reported in SDAN.
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