Healthcare Analytics for South Carolina Hospitals and Clinics

South Carolina operates approximately 75 acute care hospitals across a geographically and demographically diverse state. MUSC Health — the Medical University of South Carolina — operates 14 hospitals including a flagship academic medical center in Charleston that anchors the state's research and tertiary care capacity. Prisma Health, formed from the merger of Palmetto Health and Greenville Health System, operates 19 hospitals across the Upstate and Midlands regions, making it the largest health system in the state. Tidelands Health, McLeod Health, and Conway Medical Center serve the Grand Strand coastal region, where seasonal population surges from tourism create unusual utilization patterns. Grand Strand Medical Center, part of HCA Healthcare, competes in the Myrtle Beach market.

South Carolina Healthy Connections Medicaid has not been expanded under the ACA, leaving an estimated 255,000 adults in a coverage gap. Healthy Connections managed care is administered through Molina Healthcare, Absolute Total Care (Centene), and WellCare (Centene) — three MCOs that together cover approximately 1.1 million South Carolinians, primarily children and pregnant women who qualify under traditional Medicaid thresholds. The state's rural Pee Dee region in the northeastern interior, encompassing counties like Marlboro, Marion, and Dillon, has some of the most severe health disparities in the Southeast — high rates of poverty, diabetes, and heart disease, with limited hospital resources and significant travel burden for specialty care. South Carolina's African American coastal communities in the Low Country face documented disparities in maternal health outcomes, cancer screening rates, and chronic disease management that have been the subject of state and federal health equity initiatives.

South Carolina Healthy Connections Medicaid is administered by the Department of Health and Human Services through managed care organizations that hold risk contracts for most eligible populations. Molina Healthcare, Absolute Total Care (Centene), and WellCare (also Centene) impose HEDIS quality reporting and encounter data submission requirements on contracted providers. South Carolina's non-expansion status means managed care covers primarily the traditional Medicaid population — children, pregnant women, and certain adult categories — rather than the broader expansion population present in neighboring Georgia (which expanded) and North Carolina (which expanded 2023).

South Carolina hospitals with high uncompensated care volumes carry disproportionate share hospital (DSH) reporting obligations administered by DHHS. MIPS quality reporting applies to South Carolina physician practices, and CMS readmission reduction penalties create financial exposure for facilities serving high-risk populations with limited post-discharge follow-up access. MUSC Health's academic medical center status creates additional CMS research reporting requirements and teaching hospital cost reporting obligations.