Financial Trends of Florida Hospitals Pre and Post the Affordable Care Act

Abstract

Although Florida did not expand Medicaid via the Affordable Care Act (ACA), the state transitioned all of its full-benefit Medicaid enrollees from fee-for-service to managed care in 2014. This paper explores the financial trends in Florida hospitals in light of these significant federal and state policy changes. A linear spline with a knot at year 2014 was used to estimate the change in the slope of hospital finances before and after 2014. Florida Agency for Health Care Administration provided the Florida hospital financial data for years 2010-2018. The study sample was a panel of 1,600 unique hospital-year observations with 187 unique hospitals. The growth of Florida not-for-profit hospitals operating profits have slowed down in the post ACA years. Investor-owned hospitals appear unaffected by the ACA and maintained their dominance in the Florida hospital market. Public hospitals may have turned a corner with improving profitability.