State helping hospitals model payer-shift risks as exchange, Medicaid changes loom

Director Tony Keck said the department is working with the Hospital Association to model scenarios that could produce either net financial gains or losses for individual hospitals depending on how patients transition among payer buckets after exchanges and subsidies begin. Keck outlined the central concern: if privately insured patients move into lower-paying exchange or Medicaid products, hospitals could see revenue declines; conversely, moving uninsured patients into insured buckets could improve hospital revenues.