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This Week in Health Care Reform: August 16th, 2019

A new study shows where surprise medical bills are happening most frequently; a separate study shows how dramatically hospital prices have climbed in recent years; meanwhile, rural hospitals face an exigent threat; and, telehealth utilization soars.

Week in Review

Surprise Medical Bills: According to a new study, surprise medical bills at in-network hospitals for emergency and inpatient services are on the rise.  Published earlier this week in JAMA Internal Medicine, the analysis found that the percentage of visits to emergency departments that resulted in surprise medical bills jumped from 32.3 percent in 2010 to 42.8 percent in 2016.  The increase observed for inpatient admissions over that same period went from 26.3 percent to 42 percent.  Additionally, the total cost of the bill in both categories nearly doubled, with the top 10 percent of emergency visits resulting in bills over $1,000, while the top 10 percent of inpatient visits was over $3,000.  While Congress has been working to protect consumers from the scourge of these unexpected medical costs, its leading approach has been undermined by hospital and doctor groups, who were successful in injecting an arbitration-style model into some of the proposals currently being debated.  As that debate rages on, experts point to private equity firms as being the primary driving force behind these devious practices.

Hospital Prices: The above notwithstanding, egregious examples abound highlighting the impact that the high price of hospital care is having on patients and exacting on our health care system, writ large.  A new report draws further attention to the need to address the high – and getting higher – cost of hospital prices.  That data brief from United Health Group, which examined hospital inpatient claims from 2013 to 2017, found that hospital prices for inpatient services surged 19 percent, or about 4.5 percent per year, over that 5-year period.  Over that same period, the prices paid to physicians for providing those service also increased – 10 percent, or about 2.5 percent annually.  The brief concludes by showing a potential $250 billion savings opportunity for privately insured individuals if the industry is able to moderate hospital prices by 2 percentage points from 2020 to 2029.

Rural Hospitals: As candidates put forth plans to remake our health care system – which, rhetoric aside, currently covers 9-out-of-10 Americans – a new study takes a hard look at how some of what’s being discussed would impact the country’s already-fragile rural health infrastructure.  Despite voters prioritizing improving the current system over the proposals being discussed, one of those plans calls for the creation of a Medicare public option.  Under that proposal, the government would offer its own insurance program which would reimburse at Medicare rates on the health insurance exchanges created by the Affordable Care Act (ACA).  However, according to that new study from Navigant, that public option could jeopardize as many as 55 percent of rural hospitals across 46 states, placing them at high risk of closure.  The data tracks closely with previous research which also warns how the institution of a government-run insurance system could threaten already at-risk hospitals across the country.  One such study found that hospitals would face $62 billion in cuts “that would compound financial stresses…potentially impacting access to care and provider quality.”

Telehealth Use:
While data suggests telehealth purveyors could be doing more to better position digital technologies in order to maximize its value to patients, a new study shows rapid growth in both telehealth’s availability and popularity.  According to the research, between 2014 and 2018, telehealth utilization increased 624 percent.  During that time, communication between providers and patients via telehealth saw the greatest uptick at nearly 1,400 percent.  And, among the top reasons cited by people who sought treatment via these platforms was mental health issues, further reinforcing the important role that telehealth can play in helping patients overcome traditional boundaries (e.g., time or stigma) in seeking the care they need.      

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With Congressional lawmakers back home for August recess, it’s critical that they hear from their constituents about the issues that matter to them – issues like the surprise medical bills that continue to blindside patients at their most vulnerable.  For those that haven’t already, we still need our Health Action Network members to urge their federal elected officials to support surprise medical billing legislation that protects consumers from rising health care costs and to oppose efforts to inject an arbitration-style model into those proposals, which would only increase costs for everyone.  Thanks to the hundreds that have already taken action.  And, if you haven’t, there’s still time for you to contact your lawmakers to urge them to protect consumers from surprise medical bills and rising health care costs.

Take action today!

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