Lawmakers Push For Independent Dispute Resolution Option For Dealing With Surprise Medical Bills
The method that Reps. Joe Morelle, (D-N.Y.), Donna Shalala (D-Fla.) and Van Taylor (R-Texas) are trying to build support for is favored by many providers. Although many lawmakers want to address the issue of surprise medical bills, debate has raged over who gets stuck with the cost at the end of the day. Other news on health care costs focuses on: expensive emergency room visits, value-based care, hospital closures, and more.
Modern Healthcare:
Lawmakers May Revive Provider-Friendly Surprise Billing Proposal
Three members of the House Education & Labor Committee are shifting gears to explore a tweaked version of a provider-friendly solution to surprise medical billing. Reps. Joe Morelle, (D-N.Y.), Donna Shalala (D-Fla.) and Van Taylor (R-Texas) are circulating a letter obtained by Modern Healthcare asking their House colleagues to support surprise billing legislation founded on an independent dispute resolution process, an approach supported by providers. (Cohrs, 12/4)
California Healthline:
California Surprise-Billing Law Protects Patients But Aggravates Many Doctors
More than two years after California’s surprise-billing law took effect, there’s one thing on which consumer advocates, doctors and insurers all agree: The law has been effective at protecting many people from bills they might have been saddled with from doctors who aren’t in their insurance network. But the consensus stops there. (Andrews, 12/4)
Kaiser Health News:
‘An Arm And A Leg’: How Much For Stitches In The ER? Hard To Gauge Upfront
Sarah Macsalka had heard the stories about how expensive an emergency room visit can be, even for a minor complaint. So when her 7-year-old son, Cameron, tripped and gashed his knee in the backyard, the ER was not where her family headed first. In fact, Macsalka did just about everything she could to avoid paying a big, fat bill to get Cameron’s knee stitched up.Ultimately, she failed. (Weissmann, 12/5)
Modern Healthcare:
Value-Based Pay Still Struggles To Improve Costs, Quality
Despite progress in the movement to pay hospitals and doctors for the value of healthcare services they provide, the payment models implemented are not moving the needle on the cost and quality of healthcare, a new report suggests. More than half of commercial payments to providers are tied to the value of those services in some way. Still, most of those value-based payments are built on a fee-for-service foundation and few pose any sort of downside risk to providers, the Catalyst for Payment Reform found in its latest national scorecard on payment reform. (Livingston, 12/4)
Milwaukee Journal Sentinel:
Wisconsin Doctors Could Reduce Costs While Improving Care, Study Says
If every primary care physician in Wisconsin provided the same quality of care and was as prudent in their use of health care dollars as those in the top half for performance, the cost of treating key medical conditions would be 30% lower.That would work out to hundreds of millions of dollars in savings a year while providing better care to patients. That’s the finding of a study that analyzed millions of medical claims to gauge the performance of primary care physicians — those who specialize in family medicine, internal medicine or pediatrics — in Wisconsin. (Boulton, 12/4)
The Star Tribune:
Mayo Clinic Closing Hospital, Clinics In Southwest Minnesota
Mayo Clinic is closing its hospital and emergency department in the southwest Minnesota town of Springfield, citing troubles with recruiting patients and physicians to the medical center. The hospital and ER, as well as clinics in the towns of Springfield and Lamberton, will close effective March 1, the clinic announced this week. (Snowbeck and Olson, 12/4)
MPR:
Mayo Closes Two More Facilities, Blames Rural Health Care Crisis
The latest announcement involves a clinic in Lamberton and a hospital and clinic in Springfield. Mayo officials say the closures, slated for March 2020, will affect 60 people working in these southern Minnesota facilities. “The reasoning behind this very difficult decision … stems from what is happening in the rural health care crisis that we’re seeing not only in Minnesota, but across the U.S.,” said Dr. James Hebl, regional vice president for Mayo Clinic's health system in the southwestern part of the state. “Mayo Clinic is certainly not immune to the challenges of rural health care.” (Richert, 12/4)
Cleveland Plain Dealer:
Local Hospitals Up Community Benefit Contributions 12% To $1.6 Billion, Cleveland Clinic Contributes More Than $1 Billion
The three largest healthcare systems in Northeast Ohio increased their spending on education, charity care and other community benefits in 2018, upping contributions 12% to $1.6 billion. In 2018, MetroHealth directed the largest share of its operating revenues to community benefit, contributing 18% ($219 million). The Cleveland Clinic, meanwhile, directed 12% ($1.04 billion) of its operating revenues to community benefit, the highest dollar amount ever provided for that purpose by the Clinic. (Christ, 12/4)
