Nassau University Medical Center Faces Financial Strain Serving High Medicaid Population

Nassau University Medical Center (NUMC) on Long Island serves a disproportionate number of patients insured through public insurance programs such as Medicaid and Medicare, compared to other hospitals in the region.

In 2024, NUMC discharged 57% of its patients with Medicaid coverage, the highest percentage on Long Island, and served more publicly insured patients than any other hospital in Nassau and Suffolk counties. Medicaid and Medicare reimburse hospitals at rates below the cost of care, creating financial challenges for safety-net hospitals like NUMC, which has experienced near-annual financial losses for over 25 years.

The hospital treats many psychiatric patients and individuals requiring substance use disorder care, populations largely covered by Medicaid due to their limited employment and insurance options. The concentration of financially vulnerable patients, coupled with NUMC’s role as a critical emergency and psychiatric care provider, underscores the hospital’s essential, if financially strained, position in the region’s healthcare infrastructure. Geographic and socioeconomic factors contribute to NUMC’s patient mix; it is located near communities with higher poverty rates than the county average and serves a wide geographic area by necessity for emergency care. Other hospitals in the region have markedly different patient insurance mixes, with many serving a majority of privately insured patients, limiting their intake of Medicaid beneficiaries. There is a reported challenge for Medicaid patients to access specialty care outside of public hospitals and federally qualified health centers, largely due to limited specialist participation in Medicaid networks.

Despite the financial losses, NUMC remains crucial for patients who cannot access care elsewhere, particularly in emergency and psychiatric care domains. Hospital leaders emphasize that federal and state regulations require hospitals to provide emergency care regardless of insurance status, but non-emergency services may have more complex access barriers. While some healthcare networks assert no barriers to treating Medicaid patients, others acknowledge dependence on institutions like NUMC to serve this vulnerable population.

The hospital’s economic difficulties highlight broader systemic issues in Medicaid reimbursement and healthcare access for low-income populations, raising questions about the sustainability and future funding models for safety-net hospitals.