HEY NOW: Past-due medical bills are the reason 59 percent of Americans are contacted by a debt collector and 16 percent of Americans’ credit reports include medical debt — about $81 billion total. Yale researchers reviewed more than 8.9 million ER bills, they discovered that 22 percent of privately insured patients were treated by out-of-network doctors.
Healthline.com reported “more than 60 percent of hospitals outsource their ER doctors, and the firms they hire have an incentive to keep physicians “out-of-network” so they can charge higher prices. Nearly one-third of insured Americans learn after the fact that their health plan doesn’t pay as much for a hospital visit as expected”.
In fact “as many as 80 percent of hospital bills contain errors. And no wonder, since there are nearly 70,000 diagnosis codes and over 71,000 procedure codes to sift through”.
In Indiana, a local hospital system, Parkview Health, charged private insurance companies about four times what the federal Medicare program paid for the same care, according to a study of hospital prices in 25 states released on Thursday by the nonprofit RAND Corp.
This is one reason why our healthcare costs are climbing so rapidly. Hospitals receive $1 out of every $3 spent on health care, and the United States is projected to spend about $1.3 trillion for hospital care alone this year.
Collectively, hospitals boast a margin of 8 percent, a level higher than margins in the pharmacy industry or the insurance industry. Across America’s acute care hospitals, total revenues exceeded expenses by more than $64 billion in 2016, according to a Center for American Progress analysis. Experiences among individual hospitals vary, however, and about one-quarter of both for-profit and not-for-profit hospitals lost money in 2016.
Legislation for more transparency with hospital bills may help but there will always be hidden charges as I learned the hard way. When I had to go to the hospital following a bike crash in Boston I found out that I was being charged $15.00 for a daily vitamin and over $20 for my daily dose Lipitor.
Even those with good insurance often find that a visit to the ER can result in surprise charges because the doctor who treated them was not in their network. Are patients really going to ask a doctor, while t the ER, “are you in my network?”
What can pharma do?
Patients are consumers of healthcare and pharma needs to help them “shop”. By providing links to trusted websites that can help people evaluate costs and giving them tips on ensuring providers don’t overcharge them they can be part of the solution.