Every Provider Is Impacted by Eroding Payer Mix
Even HCA, the nation’s largest and most profitable health system, has experienced a 5.4 percentage point decrease in commercially insured revenue between 2016 and 2022. The most significant year-to-year payer mix erosion occurred between 2021 and 2022, with a 3.3 percentage point reduction.
Increasing Medicare Enrollment Continues to Reduce the Commercially Insured Population
The U.S. birth rate has been declining for over a decade (-15.1% from 2007 to 2022. The birth rate rebounded slightly in 2021 but fell again in 2022, signaling a return to previously observed trends where the number of births is not offsetting those aging into Medicare.
Number of U.S. Births Does Not Offset Those Aging Into Medicare
The U.S. birth rate has been declining for over a decade (-15.1% from 2007 to 2022. The birth rate rebounded slightly in 2021 but fell again in 2022, signaling a return to previously observed trends where the number of births is not offsetting those aging into Medicare.
Medicaid Redeterminations Will Result in Coverage Churn
The magnitude of disenrolled Medicaid lives ranges from 318 (Wyoming) to 616.6K (Texas). The extent to which the disenrolled become uninsured or gain marketplace or employer-sponsored coverage will affect the payer mix of almost every healthcare provider and access to healthcare services for millions of Americans.
But the Number of Commercially Insured Americans Continues To Steadily Decline
Commercially insured Americans account for most of the profitable revenue across the health economy. However, the share of commercially insured Americans — including employer-sponsored, Marketplace, direct-purchase and TRICARE — dropped 0.3 percentage points from 2021 to 2022.
Most Americans Have Commercial Insurance
After 2018, the uninsured rate trended down to 7.7% as of early 2023.