To determine the rate and variability of unreimbursed hospitalizations at US children's hospitals (CHs) and their implications for financial stability.
Key Findings:
Mean proportion of uncompensated hospitalizations was 3.4% (range, 1.8%-6.3%), indicating a significant financial impact on CHs.
Total cost of uncompensated care was $233.9 million, with a mean cost per uncompensated encounter of $33,105, highlighting the need for improved reimbursement strategies.
Uncompensated encounters were more likely for shorter stays, lower complexity, observation status, and patients discharged against medical advice, suggesting areas for targeted interventions.
Interpretation:
CHs experienced a mean revenue loss of $23.4 million per hospital in 2021 due to uncompensated hospitalizations, which may threaten their financial stability and ability to serve their communities.
Limitations:
Study hospitals may not represent all CHs, potentially limiting the generalizability of the findings.
Estimated costs may not reflect actual costs of care, which could affect the accuracy of financial assessments.
Supplemental payments contributing to financial stability were not included, which may underestimate the financial impact of uncompensated care.
Conclusion:
Understanding and minimizing uncompensated hospitalizations is crucial for the financial stability of CHs and their capacity to provide essential care.
