Frequently Asked Questions
What is an essential hospital?
Essential hospitals and health systems provide a significant volume of care to low-income, uninsured, and other vulnerable people. Governance structure does not define an essential hospital — some are publicly owned and operated by local or state governments and some are private nonprofits. Rather, essential hospitals are distinguished primarily by their commitment to provide community-driven care to people with limited or no access to health care due to their financial circumstances, insurance status, or health condition. Essential hospitals share four other characteristics. They:
- train the future health care workforce;
- provide comprehensive, coordinated care;
- provide specialized, lifesaving services; and
- advance public health and health equity
How are essential hospitals funded?
Essential hospitals rely on a variety of sources to fund the care they provide. A large portion of their funding comes from government programs, such as Medicare and Medicaid. In the case of members of America’s Essential Hospitals, more than half of their net revenues are from Medicare and Medicaid. Essential hospitals also receive nongovernmental funding from patients with commercial insurance and self-pay patients. Self-pay patients are defined as individuals with no form of third-party insurance. In essential hospitals, these patients generally cannot afford to pay for much, if any, of their care.
What role do essential hospitals play in their communities?
America’s Essential Hospitals represents more than 325 hospitals and health systems across the country. These essential hospitals serve a variety of vital roles in their communities. In addition to providing inpatient and outpatient care to all patients, especially the most vulnerable, they serve as communitywide resources for many kinds of specialized care. Our members train a substantial proportion of America’s physicians and other front-line providers and are the foundation of our nation’s emergency preparedness system.
Who goes to essential hospitals?
Essential hospitals provide health care to an extremely varied set of patients. They distinguish themselves from other hospitals by providing high-cost specialized services, stand-by services to all members of the community (e.g., trauma, pediatric and neonatal intensive care, and burn care), and care to the uninsured, underinsured, and other low-income populations. In 2016, three-quarters of essential hospitals’ patients were uninsured or covered by Medicaid or Medicare.