Effect of the Affordable Care Act on a Safety-Net Burn Center

We hypothesized that the Patient Protection and Affordable Care Act (ACA) would have beneficial financial effects on our burn center at a safety-net hospital. We performed a retrospective chart review of all burn patients admitted to our center from 2008-2016. These were further divided into three time periods: 2008-2010 (pre-ACA), 2011-2013 (transitional), and 2014-2016 (post-ACA). Cost and reimbursement dollars were adjusted to health personal consumption expenditures price index. Total charges increased from the pre-ACA group ($69,400) to the transitional group ($85,600) and increased again in the post-ACA group ($100,100) (p<.001). When looking at reimbursements relative to charges, actual reimbursement by percentage dropped over each time period. Despite an increase in insured patients, our burn center actually saw a decrease in reimbursements relative to billing.