Sunday, July 02, 2017

Uninsured patients in US (mostly) no longer pay crazed "list price" for hospital care

I had no idea this situation had improved — and I follow health care fairly closely ….

The Pricing Of U.S. Hospital Services: Chaos Behind A Veil Of Secrecy Uwe Reinhardt

… Until recently, only uninsured, self-paying U.S. patients have been billed the full charges listed in hospitals’ inflated charge masters, usually on the argument that the Medicare rules required it.21 This is how even uninsured middle-class U.S. patients could find themselves paying off over many years a hospital bill of, say, $30,000 for a procedure that Medicaid would have reimbursed at only $6,000 and commercial insurers somewhere in between.22

Because uninsured patients often are members of low-income families, many of them ultimately paid only a fraction of the vastly inflated charges they were originally billed by the hospital, but only after intensive and morally troubling collection efforts by the hospital.23 After a series of searing exposes of these collection efforts in the press—notably by staff reporter Lucette Lagnado of the Wall Street Journal—Congress held hearings on these practices.24 Partly under pressure from consumers and lawmakers and partly on their own volition, many hospitals now have means-tested discounts off their charge masters for uninsured patients, which bring the prices charged the uninsured closer to those paid by commercial insurers or even below.25 Some very poor patients, of course, have received hospital care free of charge all along, on a purely charitable basis…

The whole article is essential reading for journalists and anyone working in health care policy or as a healthcare executive. Hell, I didn’t know California mandated publication of hospital charge masters. Progress really is being made.

Reinhardt, by the way, is 80 years old. Long may he write.

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