Good morning. Today's word count is 699 words, or <3 minutes.
Low-income patients often face steeper out-of-pocket costs — and that means they're also more likely to be sued by hospitals when they can't pay their bills.
Driving the news: The New York Times yesterday reported on Carlsbad Medical Center's prolific use of lawsuits to collect its patients' medical debts, which often leads to wage garnishment or property liens.
Not only are patients facing more out-of-pocket spending than ever before, but hospitals — including Carlsbad Medical Center — often greatly inflate their prices compared to Medicare rates.
The bottom line: "There's a space for folks who are vulnerable to get caught in the cracks of our system ... [such as] higher cost sharing and out-of-pocket costs, skimpier health insurance plans, and more aggressive collection practices by hospitals and providers," Cooper said.
Purdue Pharma, the maker of OxyContin, is preparing to file for bankruptcy by the end of the month if it doesn't reach a settlement with the communities suing it over its role in the opioid epidemic, Reuters reports.
Why it matters: If Purdue claims bankruptcy without a payment agreement, the plaintiffs will likely receive less money than they would under the settlement Purdue pitched last month.
What we're watching: The judge overseeing the massive consolidated case wants 35 state attorneys general to agree to a deal, which hasn't happened yet.
Private equity's reach into the health care system keeps expanding, Modern Healthcare's Harris Meyer reports.
Between the lines: These deals raise obvious questions about whether they'll encourage higher health costs, along with concerns about increased pressure on doctors to provide unnecessary care.
Yes, but: Doctors see the deals as an alternative to being acquired by hospital systems, and advocates say that the private equity firms can help doctors' practices become more efficient and deliver higher-quality care.
As Congress looks to reform contracts between hospitals and health insurers, it's worth remembering that most deals get ironed out well in advance, Axios' Bob Herman writes
What they're saying: Analysts with the investment firm Jefferies recently met with executives of HCA Healthcare and heard the hospital chain locked up contractual payment rates from insurers for "75% and 50% of its 2020 and 2021 business, respectively."
The intrigue: HCA told Jefferies there was no major change in insurers' "aggressiveness" during negotiations, which can result in one or both sides going public with attacks if talks go sour.
Health insurance companies will have to pay $15.5 billion next year if the Affordable Care Act's tax on insurers resumes as planned, the IRS said in a notice on Tuesday.
The big picture: Insurers hate the tax because it eats into profits, and companies pass along the costs to consumers through higher premiums. The industry has a few months left to persuade lawmakers to delay or kill the tax, Bob writes.