Samantha Liss June 7, 2019
A longtime
hospital CEO in New Jersey is calling for price transparency — even advocating
for disclosure of negotiated prices between hospitals and insurers — as the
industry pushes back against attempts by the Trump administration to force
highly secretive rates out into the open.
"The
current healthcare market is a complex system of secret deals and discounts
between insurance companies and healthcare providers," Michael Maron,
CEO of Holy Name Medical Center in Teaneck, New Jersey — located about 14 miles
outside of Manhattan — wrote recently in a letter responding to proposed
regulations that include tackling pricing issues.
"For
decades, insurance companies and powerful provider systems have succeeded in
keeping their negotiated rates veiled from public view using non-disclosure
agreements and restrictive contractual gag clauses," he wrote.
Maron's ideas
conflict with powerful lobbying groups representing major healthcare
institutions and insurance companies.
The American
Hospital Association, of which Maron is a member, said the proposed approach of
releasing negotiated rates "misses the mark" adding price is not
the sole factor patients consider when deciding where to receive care.
"Disclosing
negotiated rates between insurers and hospitals could undermine the choices
available in the private market," Tom Nickels, executive vice
president of AHA, said in a statement. AHA represents nearly 80% of the
nation's hospitals and lobbies on their behalf.
The lobbying
group representing the nation's insurance companies also balked at the
transparency proposal, arguing the disclosure could harm competition and lead
to higher prices.
"If every
contract and every negotiated rate were public, no doctor or hospital would
want to be paid the lowest rate — they would all be motivated to demand higher
payments. And health care costs would rise for all Americans as a
result," America's Health Insurance Plans CEO Matt Eyles said in a
statement.
The push for
pricing transparency comes as more Americans rely on high-deductible health
plans for their insurance coverage. Those plans can result in consumers paying
for a greater portion of their own healthcare.
Consumer
spending has increased dramatically over the past two decades. In 1997,
out-of-pocket spending was $589 per capita, growing to $1,124 in 2017,
according to a Kaiser Family Foundation analysis of National Health Expenditure
data.
The top concern
for Americans continues to be healthcare as they fret over affordability and
access to care, a recent Gallup Poll shows. Americans worry more about
healthcare than crime or the economy.
"As
healthcare becomes more expensive and more unaffordable, the demands for price
transparency are only going to increase," Steve Wojcik, vice
president of public policy for the National Business Group on Health, told
Healthcare Dive. NBGH does not support disclosing prices negotiated
across all plans. Instead, NBGH supports patients having access to their
"out-of-pocket expenses and total plan expenses for providers and services
for the specific coverage they have," he said.
No comments:
Post a Comment