Essential hospitals share a mission to care for all people, regardless of their financial means and insurance status. Three-quarters of essential hospitals’ patients are uninsured or have Medicaid or Medicare coverage. Marginalized and underrepresented populations and communities with systemic and structural barriers to care rely on essential hospitals for health and wellness.
Along with their safety net mission, essential hospitals provide specialized, lifesaving services, such as level I trauma and neonatal intensive care; train many physicians, nurses, and other health care professionals; coordinate care across large ambulatory networks; meet public health and crisis response needs; and advance health equity.
Although essential hospitals constitute about 5 percent of all U.S. hospitals, they provide more than 27 percent of charity care nationally, leaving them with an average operating margin 60 percent less than that of other U.S. hospitals. They rely on patchwork federal support — especially Medicaid disproportionate share hospital (DSH) payments. In fact, without Medicaid DSH support, the average essential hospital would operate at a loss (right).