VCU news

By Anne Dreyfuss
C. Kenneth and Dianne Wright Center for Clinical and Translational Research

The Robert Wood Johnson Foundation awarded a $96,000 grant to the Virginia Commonwealth University School of Medicine to study how inpatient and emergency department utilization has changed at safety net hospitals in response to the Medicaid expansions outlined in the Affordable Care Act.  

The 16-month study will draw on data obtained from acute care hospitals in California, Arizona, Nevada and Washington, with California hospitals representing the majority since the state expanded Medicaid early. Researchers will examine data that includes all inpatient stays and emergency department visits from 2010 to 2013.

“We’re going to look at whether the increase in Medicaid enrollment had an effect on the use of safety net hospitals,” said Peter Cunningham, Ph.D., professor in the Department of Healthcare Policy and Research in the School of Medicine and principal investigator on the grant. “We would expect to see that they would have an increase in utilization from Medicaid patients and a decrease in utilization from uninsured patients.”  

In 2016, hospitals that serve a large number of uninsured and low-income patients will lose a lot of the federal subsidies that they have relied on to help defray the cost of undercompensated and uncompensated care. The budget cut is under the assumption that those hospitals will replace most of the lost income with payments for patients who are newly covered by Medicaid or private insurance.

“If they’re not seeing such changes then these safety net hospitals could be at very high risk,” Cunningham says. “Their financial viability might be threatened.”

VCU was selected as one of only nine institutions nationwide to be awarded a grant from the State Health Access Reform Evaluation, a national program of the RWJF. Other universities that received a grant include Columbia University, the Harvard School of Public Health and the University of California, San Francisco. The grants fund research that will provide timely insights into a variety of health reform issues, including those related to the coverage provisions of the ACA.

The study is titled “The Effect of the ACA Medicaid Expansion on Safety Net Hospital Utilization” and is supported through grant number 72180.

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