Do Uncompensated Care Pools Change the Distribution of Hospital Care to the Uninsured?

In 1983, New York State established an uncompensated care pool using the New York Prospective Hospital Reimbursement Methodology (NYPHRM). Two policy objectives of the NYPHRM were (1) to encourage more equitable distribution of uncompensated care across hospitals and (2) to increase access to hospital care for the uninsured. This article demonstrates that the New York uncompensated care pool was only moderately successful in achieving these goals. The principal findings are that the NYPHRM did result in routine care being redistributed away from hospitals that traditionally provided care to the uninsured, while provision of highly technological care was not significantly redistributed. This article suggests that if the primary policy goal is to increase access to care for the uninsured by changing the distribution of hospitals willing to provide care, the uncompensated care pool approach is moderately effective.