Study: Hospitals Still Hold The Cards In Pricing Discussions With Big Employers
A study in the American Journal of Managed Care says hospitals still wield considerable market power when it comes to self-insured employers and negotiations over billing. Hospital pricing, covid medical bills, New York hospital mergers and more are also in the news.
Becker's Hospital Review:
Large Employers Don't Have Enough Power To Negotiate Hospital Prices, Study Says
Self-insured employers face low market power, stripping them of their ability to negotiate for lower prices with providers, according to a study. Published July 13 in the American Journal of Managed Care, the study drew a line between hospital price negotiating power and employer market power. (Moran, 7/20)
Bay Area News Group:
Report: Bay Area Hospitals Not Complying With Price Transparency Rule
So you need surgery? Good luck figuring out exactly what the procedure will cost you. Not a single one of the eight California hospitals, including Stanford Hospital and UCSF Helen Diller Medical Center at Parnassus Heights, analyzed in a new report by the nonprofit Patient Rights Advocate (PRA) comply with a price transparency rule that requires medical centers to post standard charges and other information online so that patients can more easily figure out the cost of their health care upfront. The report found that just 5.6% of 500 hospitals across the country comply fully with the rule, which took effect in January. (DeRuy, 7/20)
USA Today:
Medical Bills Ruin Credit, Strain Living Expenses For COVID Patients
Americans increasingly struggled to pay their medical bills during the pandemic because of being infected with the coronavirus, losing income or losing employer health insurance coverage, a new survey shows. More than a third of insured adults and half of uninsured adults said they had difficulty paying for a medical bill. The national survey by the Commonwealth Fund between March and June 2021 asked 5,450 working-age adults about how the pandemic affected their health insurance coverage and medical debt. “They suffered ruined credit ratings. They were unable to afford basic life necessities like food, heat or their rent,” said lead author Dr. Sara Collins, Commonwealth Fund's vice president for health care coverage, access and tracking. (Avery, 7/20)
In other health care industry news —
Axios:
UnitedHealthcare Luring New Members With Peloton Perk
UnitedHealthcare said Tuesday it will pay for either a 12-month digital Peloton membership or a four-month "all-access" Peloton membership (each costs $156) for workers who are in a fully insured plan. Health insurers want their members to be as young and healthy as possible so they don't have to pay out as much in medical claims. UnitedHealthcare is attempting to attract more of this affluent, healthy crowd through this Peloton perk. (Herman, 7/20)
Modern Healthcare:
Returning Patients Meant Higher Profit For HCA In Q2
For-profit hospital giant HCA Healthcare is benefiting from a rebound in patient traffic this year after a dismal 2020 marked by COVID-19 shutdowns and anxious patients delaying care. HCA's admissions jumped 17.5% year-over-year in the second quarter of 2021, which ended June 30. The biggest gains occurred in outpatient surgeries, emergency room visits and urgent care visits, the company disclosed in its financial statement. (Bannow, 7/20)
Modern Healthcare:
Dignity Health, Anthem Blue Cross Terminate California Contract
Anthem Blue Cross and Dignity Health could not agree on new contract terms, removing more than two dozen Dignity hospitals, medical groups and clinics across California from Anthem's network as of July 16. Dignity, which is part of CommonSpirit Health and has the largest hospital network in California, threatened to end its contract for the vast majority of its Anthem business if the insurer didn't agree to "excessive rate increases that will make care at Dignity even less affordable," Anthem Blue Cross said. The contract termination impacts Anthem commercial PPO, EPO, HMO and POS members as well as some Medicaid and Medicare Advantage policyholders, but the company could not specify how many customers were affected. (Kacik, 7/20)
Becker's Hospital Review:
New York Hospitals Combine
Two New York City hospitals, Maimonides Medical Center and New York Community Hospital combined to form a new local health network in the Brooklyn borough, the organizations said July 19. The formal agreement builds on a clinical service agreement in place since 2018.Under the agreement, which recently received state approval, the 711-bed Maimonides Medical Center will be a co-operator of the 134-bed New York Community Hospital. (Paavola, 7/20)
