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Because the program aims to reduce hospital visits, hospitals also

Jan. 24, 2019 by Catherine Pope

Because the program aims to reduce hospital visits, hospitals also must be able to give patients the chance to get the right care, which means that they can't spend the money without giving them all up. "There's a real urgency to getting people covered, so that you do it right," said Dr. John DeLong, a health care policy analyst with Kaiser.

Many of the hospital's top practices are already receiving significant budget cuts, and there are questions about their effectiveness, DeLong said. "For a long time, the program was really designed to help hospitals," he said. "We started seeing the effects of Medicare cuts in 2008 and 2009. These changes really hurt patients in all sorts of ways."

KHN's Cinzia Sosa-Reyes is a member of the Washington health policy team.

"We are seeing a shift to private insurance in the U.S., which means more and more people are having to rely on state, local and federal health care providers for care," said Sosa-Reyes.

Health care is now more closely tied to the federal government, the report found, with nearly half of Americans now participating in a group of private health plans, according to the Kaiser Health News. (See more at Kaiser Health News.)

But it also means that hospitals have a bigger budget than they ever have before, and are being forced to pay a penalty for not providing the proper care. The Centers for Medicare and Medicaid Services (CMS) was one of the first agencies to look into this issue, when it conducted a review of about 200,000 Medicare patients' Medicare claims in 2015. "This is a really big problem, because it's not just the one-percent cut that's going away," said Susan Stokes, the CMS director in charge of the program.

The CMS also is looking into private insurance premiums, which are now higher than they were in 2008. But CMS did not provide any data for those payments, which are usually paid through the health plans that most cover Medicaid. CMS said it is not working with private insurers to create a new Medicaid expansion program.

The report also found that hospitals are now receiving more money out of the federal government than they ever had before. According to the Kaiser Health News report, out-of-pocket costs for Medicaid beneficiaries in 2015 were $2,079 and $3,633 for hospital-acquired infections, respectively. That's more than double the amount they received from the private plans of the previous year.