In Theory, Legislation To End Surprise Medical Bills Enjoys Bipartisan Support. Reality Is A Little More Complicated.
Some Democrats are wary about handing a health care win to President Donald Trump and Republicans this close to elections. That doesn't even account for the big players in the industry gearing up to block the bills with all the lobbying power they can muster. In other health industry and costs news: hospital mergers, Medicare Advantage, providers' affiliates, and using Groupon for medical treatments.
Push On 'Surprise' Medical Bills Hits New Roadblocks
A bipartisan push for legislation to protect patients from massive "surprise" medical bills is facing a buzzsaw of opposition from doctors and hospitals and reservations from some Democrats worried about delivering President Trump a health care victory when he is still attacking ObamaCare. The surprise billing measure has support from bipartisan committee leaders in both the House and Senate, patient advocates and insurers — and was moving forward quickly before Congress left town for August. It was seen as one of the most promising avenues for lawmakers to target health costs this year. (Sullivan, 9/5)
American Hospital Association, Economists Debate Merits Of Mergers
A hospital trade group and healthcare economists squared off on the impact of hospital mergers, a debate that will continue to resonate amid an increasingly consolidated industry. The American Hospital Association commissioned a new study Wednesday that supports mergers and acquisitions, making the case that they reduced costs at acquired hospitals and boosted care quality. Economists hosted a discussion following the report's release, sharing their research on how consolidation typically raises prices, often doesn't produce the expected savings and can diminish quality. (Kacik, 9/4)
Medicare Advantage Has Little Impact On Traditional Medicare Spending
Medicare Advantage market share has little effect on how physicians care for or code their fee-for-service patients, according to new research from the Medicare Payment Advisory Commission on Thursday. Many health experts believe Medicare Advantage's growing rolls have "spillover" effects on traditional, fee-for-service Medicare because most physicians care for both types of patients. As Medicare Advantage grows in popularity, they hoped that would induce physicians to practice lower-cost medicine and code more. (Brady, 9/5)
CMS Targets Healthcare Providers' Affiliates In New Rule
The CMS will be able to revoke healthcare providers or suppliers' Medicare enrollment if they are affiliated with targeted "bad actors," a final rule issued Wednesday established. As part of the CMS' "Program Integrity Enhancements to the Provider Enrollment Process" going into effect Nov. 4, its new "affiliations" provision allows authorities to bar individuals and organizations that "pose an undue risk of fraud, waste or abuse based on their relationships with other sanctioned entities." (Kacik, 9/5)
Kaiser Health News:
Groupons For Medical Treatment? Welcome To Today’s U.S. Health Care
Emory University medical fellow Dr. Nicole Herbst was shocked when she saw three patients who came in with abnormal results from chest CT scans they had bought on Groupon. Yes, Groupon — the online coupon mecca that also sells discounted fitness classes and foosball tables. (Weber, 9/6)