Aug 31, 2018

Why there's no surprise hospital bill backlash — yet

A hospital waiting room. Photo: Patricia De Melo Moreira/AFP/Getty Images

Investigative projects from Kaiser Health News/NPR and Vox have exposed pernicious billing practices from hospitals and doctors that have left patients shocked, angered and exasperated.

The bottom line: Hospitals have taken PR hits with the airing of surprise bills, but nothing suggests their practices will change in the short term.

Driving the news: The $109,000 heart attack bill, reported by KHN's Chad Terhune, went viral this week, and the hospital eventually caved by offering to wipe away 99% of the amount billed.

  • This was an extreme example of a family getting blindsided, but "in smaller amounts, $10,000, $20,000, it happens all the time," KHN editor-in-chief Elisabeth Rosenthal told "CBS This Morning."
  • More than half of U.S. adults "have been surprised by a medical bill that they thought would have been covered by insurance," according to a new survey from research group NORC at the University of Chicago.
  • However, every American facing medical debt does not have their own personal investigative journalist.

The big picture: Drug prices have been in the crosshairs of lawmakers, and health insurers have always been a punching bag. But hospitals and doctors aren't attracting any large-scale movement to rein in pricing and billing tactics.

  • "There's a huge amount of trust in the providers people choose to go to," said Caroline Pearson, senior fellow at NORC. "I think we've got a long way to go until we have backlash against those providers. But as insurance gets more complicated and out-of-pocket costs rise, we're going to see more and more surprise bills."

The other side: Ashley Thompson, SVP of policy at the American Hospital Association, said in a statement that "patients and their families should be protected from...unexpected medical bills," but "insurers have the primary responsibility for making sure their networks include adequate providers."

Looking ahead: Medicare for All and all-payer rate setting are the most direct ways to eliminate surprise bills, but the industry is not about to support those policies.

  • America's Essential Hospitals, the lobbying group for safety net hospitals that presumably would have the most to gain from rate setting, has "no formal policy position" on Medicare for All.

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