States Have Been Leading The Charge Against Surprise Medical Bills–Can Congress Catch Up?
At least 25 states now have laws protecting patients from surprise out-of-network bills. Now, there's starting to be more movement in Congress over the issue, which both Republicans and Democrats have spoken out against. In other news: outpatient prices outpace in-office costs for same treatments, and why cash rewards are powerful enough to change consumers' behavior.
Surprise Medical Billing: Some States Ahead Of Feds
At least 25 states now have laws protecting patients from surprise out-of-network bills, usually for emergency care they received at hospitals or ambulatory surgical centers. At least 20 states are considering legislation this year, according to the National Academy for State Health Policy. While states have provided protections for consumers with commercial health insurance plans, the laws do not apply to self-insured employer-sponsored health plans, which cover 61% of privately insured employees, according to the Kaiser Family Foundation. (Ollove, 4/5)
Alexander Eyes Summer Committee Vote On Health Care Cost Bill
Sen. Lamar Alexander is planning a vote on a package of bills seeking to curb health care costs in the Health, Education, Labor and Pensions Committee early this summer, he said Thursday in a speech on the Senate floor. Alexander, who chairs the panel, is working with ranking member Sen. Patty Murray, D-Wash., and Finance Committee leaders Charles E. Grassley, R-Iowa, and Ron Wyden, D-Ore., on legislation to lower health care costs. The two panels share jurisdiction over health issues, and the Finance Committee has been probing the cost of prescription drugs this year, although Grassley has also indicated a broader interest in health care costs. (McIntire, 4/4)
Outpatient Prices Exceed Physician Office Prices
Outpatient prices consistently exceeded prices for the same treatment delivered in office settings, underscoring the potential impact of site-neutral payments, according to new research. Health Care Cost Institute researchers looked at a set of nearly 30 services deemed to be safe and appropriate to provide in freestanding physician offices by the Medicare Payment Advisory Commission. Their analysis of commercial insurance claims from 2009 to 2017 found that more of that care shifted to outpatient facilities where the average price was always higher. (Kacik, 4/4)
Why Even Cash Rewards May Not Turn Patients Into Health Care Shoppers
There are lots of reasons patients don't shop for health care. Many follow a doctor's referral and don't look at their options. Others, like Hurley, don't have a reason to compare prices. And some patients who do review the cost of a test may assume that the higher-priced labs or hospitals deliver the best care — even though that is often not the case. (Bebinger, 4/5)