Public Hospitals Face Enormous Challenges under Health Reform

To survive health reform, public hospitals will have to start operating more like private hospitals or else dramatically cut costs, according to a report by the Texas Tribune.

To compensate for losses in disproportionate share hospital funding for uncompensated care, some public hospitals may add new service lines, such as orthopedic and spine surgery, but small public hospitals may not have the funds to do so.

Health reform gives Medicaid coverage to patients who formerly sought uncompensated care, but if these patients can’t link up with primary care physicians, as many observers fear, they may be back in public hospitals' EDs.

Further, public hospitals treating large numbers of undocumented immigrants would not be compensated because these patients will not be covered.

New problems created by the reform law are going to require timely solutions, but a highly polarized Congress might not be up to the task.

Read the Texas Tribune's report on health reform.