The American Hospital Association is pushing for CMS to create a special designation to help ensure the sustainability of a subset of urban safety net hospitals.
The AHA said about 465 hospitals — just over one of every eight urban hospitals — would meet the requirements for what it calls Metropolitan Anchor Hospitals, according to an Oct. 24 AHA fact sheet. Eligibility requirements would include being located in a core-based statistical area and having a Medicaid inpatient utilization rate greater than the statewide averages (see the full list of requirements here).
The qualifying hospitals are critical access points for primary care, preventative services and specialized healthcare services in communities that include low-income and are often challenged in accessing comprehensive, quality healthcare, the AHA said. The hospitals also serve as de facto public health entities in their communities.
Metropolitan Anchor Hospitals serve a significant proportion of Medicare, Medicaid and underinsured patients and are "therefore largely dependent on government payers and patients who are unable to pay for care," according to the fact sheet.
These hospitals reported $15 billion in uncompensated care costs in 2019. That year, half of Metropolitan Anchor Hospitals operated at a loss, more than twice the national average for all hospitals, according to the fact sheet. Chronic underfunding leaves these facilities without necessary funds to repair and modernize their stressed infrastructure and makes them vulnerable to closures.