+ Site Statistics
+ Search Articles
+ PDF Full Text Service
How our service works
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ Translate
+ Recently Requested

Facing the recession: how did safety-net hospitals fare financially compared with their peers?



Facing the recession: how did safety-net hospitals fare financially compared with their peers?



Health Services Research 49(6): 1747-1766



To examine the effect of the recession on the financial performance of safety-net versus non-safety-net hospitals. Agency for Healthcare Research and Quality Hospital Cost and Utilization Project State Inpatient Databases, Medicare Cost Reports, American Hospital Association Annual Survey, InterStudy, and Area Health Resource File. Retrospective, longitudinal panel of hospitals, 2007-2011. Safety-net hospitals were identified using percentage of patients who were Medicaid or uninsured. Generalized estimating equations were used to estimate average effects of the recession on hospital operating and total margins, revenues and expenses in each year, 2008-2011, comparing safety-net with non-safety-net hospitals. 1,453 urban, nonfederal, general acute hospitals in 32 states with complete data. Safety-net hospitals, as identified in 2007, had lower operating and total margins. The gap in operating margin between safety-net and non-safety-net hospitals was sustained throughout the recession; however, total margin was more negatively affected for non-safety-net hospitals in 2008. Higher percentages of Medicaid and uninsured patients were associated with lower revenue in private hospitals in all years, and lower revenue and expenses in public hospitals in 2011. Safety-net hospitals may not be disproportionately vulnerable to macro-economic fluctuations, but their significantly lower margins leave less financial cushion to weather sustained financial pressure.

Please choose payment method:






(PDF emailed within 0-6 h: $19.90)

Accession: 053189001

Download citation: RISBibTeXText

PMID: 25220012

DOI: 10.1111/1475-6773.12230


Related references

Safety-net hospitals more likely than other hospitals to fare poorly under Medicare's value-based purchasing. Health Affairs 34(3): 398-405, 2015

Shifts in Medicaid and Uninsured Payer Mix at Safety-Net and Non-Safety-Net Hospitals During the Great Recession. Journal of Healthcare Management / American College of Healthcare Executives 63(3): 156-172, 2018

Practitioner Application: Shifts in Medicaid and Uninsured Payer Mix at Safety-Net and Non-Safety-Net Hospitals During the Great Recession. Journal of Healthcare Management / American College of Healthcare Executives 63(3): 173-174, 2018

Hospital CMO pay up. But their peers didn't fare as well. Modern Healthcare 41(2): 34-34, 2011

Rising to the top. Facilities named to the annual 100 top hospitals roster outperform their peers in quality, safety and efficiency. Modern Healthcare 38(11): 26, 28-30, 2008

Six to eight hospitals may benefit from aid to financially distressed hospitals; AHA urges long-term solution for all. Health Law Vigil 3(19): 1-2, 1980

General hospitals, specialty hospitals and financially vulnerable patients. Research Brief: 1-8, 2009

Financially Overextended: College Attendance as a Contributor to Foreclosures During the Great Recession. Demography, 2018

Arterial compliance is increased in children with type 2 diabetes compared with normal weight peers but not obese peers. Pediatric Diabetes 14(4): 259-266, 2013

Hospitals that cooperate on infection control fare better than hospitals acting alone. 2012

Hospital financial performance in the recent recession and implications for institutions that remain financially weak. Health Affairs 33(5): 739-745, 2015

'17% of hospitals financially distressed'. Modern Healthcare 21(17): 12-12, 1991

Turning around financially distressed hospitals. Healthcare Financial Management 44(5): 44, 46, 48-52, 1990

100 top hospitals. They 'just do it better'. Elite group of hospitals making Solucient's annual list--including 31 newcomers this year--outperform their peers across the board. Modern Healthcare Suppl: 6-12, 2003

Conversions: remedy for financially troubled hospitals?. Healthspan 8(1): 10-12, 1990