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Nevada hospitals warn Medicaid cuts would raise uncompensated care and strain services
Summary
The Nevada Hospital Association and individual hospital leaders told legislators that Medicaid reductions or provider tax limits could increase uncompensated care, reduce services and lead to capacity cuts, with safety-net hospitals most at risk.
Hospital executives told a joint session of the Assembly and Senate Health and Human Services Committees that cuts to Medicaid funding or limits on provider tax programs would increase unreimbursed care and could force reductions in services or capacity.
"We have 31% of inpatients who are Medicaid recipients," Patrick Kelly, CEO of the Nevada Hospital Association, said in his presentation, noting that many hospitals already treat more patients at below-cost reimbursement: "We have 78.5% of our patients who pay less than their actual cost of care." He told the committee that hospitals in the provider-fee program are projected to pay about $387 million and receive a net benefit of about $830 million under the current design; delays in federal approvals have already slowed some payments.
Kelly and other hospital representatives outlined three possible federal changes that would materially affect hospital revenue streams: a reduction in the expansion match, a lower cap on the amount states may tax providers (moving from 6% to 4% in some proposals), and lower allowable supplemental payments tied to commercial/Medicare benchmarks. Administrator Stacy Weeks earlier noted a roughly $336 million federal hit to the hospital tax payment program in a 90% FMAP rollback scenario; Kelly said a 5% cut to base Medicaid rates statewide would amount to about $41 million for hospitals and would return rates to early-2000s levels.
Hospital leaders warned of likely downstream effects: longer emergency-department waits, a higher uninsured population relying on EDs for care, reduced expansion of behavioral health initiatives, potential reductions in bed capacity and deferred capital projects. They said smaller hospitals and safety-net institutions with higher shares of Medicaid patients would be most exposed.
Lawmakers asked for hospital-specific payer-mix data and for estimates showing how particular hospitals — especially trauma and safety-net centers — would be affected. Kelly and his staff said they would provide additional data to the committee.
Ending: Hospital executives urged early planning and requested state engagement to identify mitigation options should federal changes reduce Nevada’s Medicaid funding.
