Data: Sun, Mello, Moshfegh and Baker, 2019; Chart: Harry Stevens/Axios

Surprise medical bills have gotten more common and more expensive, according to a new study published in the Journal of the American Medical Association.

Why it matters: These bills can be devastating to patients, even those who have some savings and a steady source of income.

The big picture: The study used an Optum database to look at patients covered by a large commercial insurer who received either inpatient or emergency care at hospitals covered by their insurance, and got a bill for out-of-network care.

  • These bills were probably unexpected. Patients often assume that the care they receive at an in-network hospital will all be covered by their insurer.

Yes, but: Most hospitals don't produce out-of-network bills this often. The results are skewed by serial offenders.

What we're watching: Congress has vowed to prohibit surprise medical bills, but its leading approach is under attack from hospital and doctors' groups.

California's law, which mirrored the approach pending in Congress, shifted contract negotiations in insurers' favor, according to a study in the American Journal of Managed Care.

  • This has led to even more provider consolidation, the study found.

Go deeper: We all pay for surprise emergency room bills

Go deeper

Updated Aug 4, 2020 - Axios Events

Watch: How hospitals have responded to the pandemic

On Tuesday, August 4 Axios health care reporter Caitlin Owens hosted a virtual event on how hospitals have been responding to the coronavirus pandemic, from getting PPE to building the future of resilient health systems, featuring Atrium Health CEO Eugene Woods, K Health co-founder & CEO Allon Bloch and Columbia University Medical Center professor and FemInEm founder Dr. Dara Kass.

Allon Bloch argued that a rise in the usage of telemedicine presents an opportunity for people to reimagine how the U.S. health care system can be more efficient and cost-effective.

  • On integrating more data analysis into medicine: "There's a massive opportunity to give people a much more nuanced approach to medicine, a much more personalized one, based on information [from] their own personal history or from similar situations...It's a little bit overlooked in medicine."
  • On how telemedicine can positively impact the health care system: "There's a lot of people that are either not insured or underinsured. They have really high deductibles. They can't afford doctors...[telemedicine] can give people access to really high quality primary care at a much lower cost."

Eugene Woods discussed his company's "virtual hospitals" and how this model has the potential to reduce overflow into physical hospitals.

  • On his company's "virtual hospital" treating COVID-19 patients: "We've treated about 13,000 patients in our virtual hospital and only three percent have had to be transferred or admitted from the virtual hospital into [a physical] hospital."
  • On reducing disparities in COVID-19 testing: "[Coronavirus] has laid bare the racial disparities that have existed in these communities for decades...Back in March, we realized there were disparities in terms of testing. So we have roving medical vans and went into those [affected] communities. We so far have hit about 55 different community host sites."

Dr. Dara Kass unpacked her experience of working in the ICUs in New York City during the initial COVID-19 outbreak, and how safety measures like masks and social distancing impacted the rate and spread of the virus.

  • How wearing masks reduces the volume of COVID-19 patients coming to the ICU: "We saw the effects of our work of social distancing and wearing masks as early as April take effect pretty dramatically...We also saw the peak come down as almost as quickly as it went up."
  • How this crisis compounds existing gender inequities: "Our child care crisis was bad before, pay inequity was bad before — it's exacerbated by this at this moment. We're worried about frontline healthcare workers now, not even being able to go back to work because of the fact that child care will be inaccessible and schools are probably not going to open."

Thank you Philips for sponsoring this event.

Lawmakers demand answers from World Bank on Xinjiang loan

Illustration: Sarah Grillo/Axios

U.S. lawmakers are demanding answers from the World Bank about its continued operation of a $50 million loan program in Xinjiang, following Axios reporting on the loans.

Why it matters: The Chinese government is currently waging a campaign of cultural and demographic genocide against ethnic minorities in Xinjiang, in northwest China. The lawmakers contend that the recipients of the loans may be complicit in that repression.

Obama: Americans could be "collateral damage" in Trump's war on mail-in voting

Photo: Zahim Mohd/NurPhoto via Getty Images

Former President Barack Obama tweeted Friday that everyday Americans could become "collateral damage" if President Trump continues to attempt to slash funding for the U.S. Postal Service as part of his campaign against mail-in voting.

Why it matters: Trump linked his baseless claims that increased mail-in voting will lead to widespread voter fraud on Thursday to the current impasse in coronavirus stimulus negotiations.