Hold the presses! We have a modern day Easter Sunday miracle! The Charlotte Observer used logic and reason in one of its editorials. They for once agreed with North Carolina Republicans on a legislative matter. Who says the Lord doesn’t work in mysterious ways?I, like many others, have written about the rising cost of health care. One of the inflationary factors is our third-party payer system. Hospitals are not held accountable for what they charge. Finally, North Carolina’s General Assembly decided to do something about it. Here are some of their proposals, as reported in the News & Observer:
• Require hospitals to report prices for their 50 most common “episodes of care,” such as tonsillectomies. The information would be sent to the nonprofit North Carolina Health Information Exchange, which would make the information publicly available on its web site. Hospitals would have to report how much uninsured patients, Medicare, Medicaid and the five largest insurers pay for each episode of care.• Mandate that every hospital conspicuously post its charity care policy – both on its premises and on its website – along with the amount it spent on charity care in the previous year. The newspapers’ investigation found that most North Carolina hospitals were spending less than 3 percent of their budgets on free care for the poor and uninsured.
While most hospitals have charity care policies, patients don’t always learn about them. More than a third of the state’s hospitals provided no details about their charity care policies on their websites, the newspapers found.
• Prohibit hospitals from charging multiple times for outpatient radiology services that are rendered only once.Blue Cross and Blue Shield of North Carolina says such overcharging often happens when technicians take several images of a patient during radiology scans. For each image, hospitals often bill identical “technical component” fees – for such things as setting up IV fluids – even though the setup is performed only once. Blue Cross has been battling hospitals over that practice.
• Reward hospitals that have low Medicaid costs. Under a system used to maximize federal Medicaid funding, North Carolina requires most hospitals to pay an up-front assessment each year. The state then uses that money as a match to draw federal Medicaid dollars, and returns most of the money assessed to the hospitals. If the new legislation passes, the state would return most of the assessment dollars to hospitals with low Medicaid costs.• Ban hospitals owned by the state – including UNC Hospitals – from seizing the tax refunds of patients who don’t pay their bills. Only state-owned hospitals have this power. “It’s a fairness issue,” said Brown, who co-chairs the Senate Appropriations Committee. “…We’re trying to level the playing field so everyone is treated the same.”
• Encourage a change in leadership at Community Care of North Carolina, a much-praised program aimed at helping Medicaid recipients stay healthy and avoid trips to emergency rooms.
And for good measure here is what the Disturber had to say about that Republican idea of health care savings accounts:But as insurance deductibles have spiked and more Americans have taken advantage of Health Savings Accounts, consumers have become more attuned to that last line of the medical bill. And while hospitals say rightly that the price of a procedure is subject to the varying costs of everyone in the operating room, some medical markets have shown that putting it all together is possible. Cosmetic surgeons, for example, offer upfront estimates.
Such transparency, on a wider scale, can benefit both patients and providers. If hospitals must show you what procedures cost, they’ll be motivated to justify those costs with better outcomes and efficiencies. It’s called competition, but first we have to ask. We applaud Sens. Rucho and Brown for doing so.
This might be the second coming after all!