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Surprise Medical Billing Problem Growing Worse

Insured patients are getting more surprise medical bills, and more expensive surprise medical bills, even as Congress attempts to tackle this problem.

According to a new study, 42.8 percent of emergency department patients now receive surprise medical bills for out-of-network services, up from 32.3 percent in 2010, with those surprise bills rising from a mean of $220 in 2010 to $628 in 2016.

Patients experience similar frustrations with inpatient visits, with surprise bills for out-of-network services arriving in the mailboxes of 42 percent of patients in 2016, up from 26.3 percent in 2010.  Those surprise bills rose from a mean of $804 in 2010 to $2040 in 2016.

The most common reason for a surprise medical bill?  Ambulance service, with more than 85 percent of patients who arrive at a hospital emergency department via ambulance receiving a surprise bill and more than 81 percent of patients served on an inpatient basis who use ambulances receiving such bills.

Learn more about how the surprise medical bill problem continues to grow, despite state and federal efforts to address it, in the JAMA Internal Medicine study “Assessment of Out-of-Network Billing for Privately Insured Patients Receiving Care in In-Network Hospitals.”

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New Public Charge Rule Could Affect Immigrants, Providers

Legal immigrants may become reluctant to seek government-sponsored health care and providers may find themselves delivering more uncompensated care in the wake of the adoption of a new federal “public charge” regulation that seeks to define more narrowly the kinds of individuals who should be granted entry to the U.S. in the future.

The new Department of Homeland Security regulation, while focused on applicants for entry into the U.S., could have the unintended effect of discouraging legal immigrants from enrolling in Medicaid, CHIP, and other government programs and even lead them to disenroll from such programs out of a mistaken concern that participating in such programs could jeopardize their status as legal immigrants.  The Kaiser Family Foundation, in fact, estimates that two to three million people will leave Medicaid and CHIP because of the new regulation.

More than a quarter of a million interested parties responded to the proposed regulation, which was published last October, and since its release last week a wide variety of groups, ranging from the American Hospital Association and America’s Essential Hospitals to the American Council of Pediatrics, have noted the new regulation’s potential impact with alarm.  Hospitals, in particular, are concerned that if people disenroll …

Update Patient Satisfaction Survey, Hospital Groups Suggest

The survey that asks patients about their satisfaction with their hospital experience should be revised, several hospital groups have declared.

The Hospital Consumer Assessment of Healthcare Providers and Systems survey has become outdated and needs revision, according to the Federation of American Hospitals, the American Hospital Association, America’s Essential Hospitals, the Association of American Medical Colleges, and the Catholic Health Association of America.

According to the hospital groups, the 32-question HCAHPS survey needs to be updated to address more effectively matters involving value-based care, health care technology, patient priorities, and post-discharge transitional care.  The groups also called for the survey to be shortened and for it to be available for patients to respond to digitally.

Learn more in Modernizing the HCAHPS Survey:  Patient Experience Leaders Modernizing the HCAHPS Survey, the report that presents the hospital groups’ findings and recommendations.…

Governors Look at Surprise Medical Bills

While action on surprise medical bills may be slow in coming at the federal level, many states have introduced measures to address this challenge and others are exploring possible actions.

Since 2017, 11 states have introduced surprise medical bill laws, six of them doing so this year alone.

Surprise billing is an issue of importance to the nation’s governors, and their professional group, the National Governors Association, has prepared a report outlining the key issues they must address when attempting to craft surprise billing policies.  Learn more about what governors view as the key considerations in developing such policies in the National Governors Association report Protecting Consumers From Surprise Medical Bills:  Considerations for Governors.

New Client

DeBrunner & Associates is pleased to welcome our newest client:  the University of Pittsburgh Medical Center.

As Pennsylvania’s largest non-governmental employer, with more than 87,000 employees, UPMC consists of more than 30 hospitals, more than 700 doctors’ offices and outpatient sites, an international division, and an enterprises division.

Welcome!…