Study: 1 out of 6 trips to hospital result in "surprise" medical bills

[DonViejo]

Source: CBS News/The AP



JUNE 20, 2019 / 6:49 AM / CBS/AP

Roughly one in every six times someone is taken to an emergency room or checks in to the hospital, the treatment is followed by a "surprise" medical bill, according to a study released Thursday. And depending on where you live, the odds can be much higher.

The report from the nonpartisan Kaiser Family Foundation finds that millions of people with what's considered solid coverage from large employers are nonetheless exposed to "out-of-network" charges that can amount to thousands of dollars. It comes as congressional lawmakers of both parties and the Trump administration move to close the loophole, with a Senate panel scheduled to vote on legislation next week.

A patient's odds of getting a surprise bill vary greatly depending on the state he or she lives in. Texas seems like a bit of a gamble, with 27% of emergency room visits and 38% of in-network hospital stays triggering at least one such bill. Minnesota looks safer, with odds of 2% and 3%, respectively.

Researcher Karen Pollitz of the Kaiser Foundation said the reasons for such wide differences are not entirely clear, but seem to be related to the breadth of hospital and doctor networks in each state, and the ways those networks are designed.

Read more: https://www.cbsnews.com/news/study-1-out-of-6-trips-to-hospital-result-in-surprise-medical-bills/

[Hoyt]

1. This is an easily corrected abuse of patients. If an in-network hospital or medical clinic treats a

patient, the hospital or medical clinic should be responsible for using providers who are either in-network, or who agree to accept in-network payment rates.

The patient has no way of knowing whether pathologists, anesthesiologists, radiologists, consulting physicians, labs, etc., are in-network. Hospital administrators and clinic owners/administrators need to be held accountable.

Yeah, I know we could supposedly avoid this with a singe payer system. But we don't have single payer, yet.

[yellowdogintexas]

4. Anesthesiologist, pathologists, radiologists, ER physicians generally stay out of network

because they don't need to. No surgery is going to happen without anesthesia, lab and xray are vital for diagnosis and ER docs are vital. Sometimes these services are provided by persons who are actual employees of the hospital and their services will be handled differently.

Some insurances require that out of network providers who provide services within a network facility must be treated as in network, but there are not many of those.

there are so many highly convoluted and ridiculous rules which make it difficult to get services. It is just wrong

[Hoyt]

6. But a hospital can say, "Accept network rates or we'll find anesthesiologists, etc., who will."

A clinic can do the same. Patients need to complain to hospitals and clinics who don’t have the guts to do this.

I could go out tomorrow and find pathology, anesthesiology, radiology, etc., groups almost anywhere in the country who would agree to accept network rates (even if they don’t participate with the plan) for referrals.

Just takes caring enough about the patients not to refer to docs who only care about their income and what the can get away with.

[area51]

2. We need

comprehensive Medicare for All.

[yellowdogintexas]

5. one of the best features of traditional Medicare B: No Networks.

Inpatient lab and path are covered 100%

I love Medicare

[Phoenix61]

3. One more reason for single payer. nt