news Various testimonies regarding cumulative medical costs

A wide range of bills aimed at lowering the Hoosiers’ health care costs received a range of reviews at a committee on Tuesday, ranging from provisions penalizing hospitals for high medical costs to curtailing the use of non-compete agreements. .

Carmel Republican Rep. Donna Shively introduced the bill’s components before the House Public Health Committee, which heard testimony this week and agreed to amend the bill before next week’s vote.

She said the bill, along with related bills to be heard on Wednesday, are the result of a lack of action by medical institutions and insurance companies to bring prices down.

“Indiana has a very concentrated market, with a large group of physicians employed by the hospital system,” Schaibley said. “This is much needed in Indiana.”

Expensive hospital liquidation

Hospitals whose services cost more than 260% of the federal Medicaid reimbursement rate will be fined to reduce healthcare costs across the board.

“We are focused on large non-profit hospitals,” said Schaibley. “Most of them have very large reserves and I think they can absorb them.”

Indiana Hospital Association President Brian Tabor warned of possible unintended consequences from the bill’s “punitive element” and urged legislators to work with hospitals when it comes to fair pricing.

“As long as prices are fairly measured and not distorted by some other means, we believe there is a path to achieving national averages in prices,” Tabor said.

In his testimony, Tabor argued that portraying hospital prices as above average was misleading, and that Indiana was actually closer to the middle and could get there without government intervention.

“These are very complex institutions and very complex negotiations. If the law limits it, I think it will be very difficult to achieve that goal,” he said. , I think we can get there if we move away from this[at the General Assembly]to more committees, a longer term oversight with an accountability type model.”

Hospitals attribute costs to outside forces

Executives from a major state health care provider told the commission that the price was not the result of their policies, but a combination of the Hoosiers’ pre-existing poor health, high labor costs, drug prices and medical equipment. .

“We will be providing people with invoices for things they purchase elsewhere (medicine, medical equipment, various treatments, etc.).We do not set prices for these,” said Community Health Network Bryan Mills, President and CEO, said. “Our influence is also limited, so I’m not going to sympathize. What I’m trying to say is that it’s not that simple.”

Mike Schroyer, president of Baptist Health Floyd in New Albany, said his hospital runs at a loss and provides $14 million in charitable or non-reimbursed health care annually. He said the bill would cost his healthcare system an estimated $30 million, which he doesn’t have.

Bryan Mills, President and CEO of Community Health Network, said: (Photo from Community Health Network website)

“We need no reminder that our friends in the insurance market have enjoyed exceptional profit margins over the years.

In particular, delays in waiting for pre-approval strain the system, Schroyer said. Because the patient is sitting in a bed that can be used for someone else.

Earlier authorizations were originally claimed as a way for providers and health care beneficiaries (insurers or individuals) to work together to guarantee payment. Over time, using previous authorizations created more administrative burden for both parties.

From CEOs to primary care physicians, they pointed out the low profit margins for physicians treating Medicaid patients. This is understandable to both Chairman Brad Barrett, a retired physician, and Commission member Rita Her Fleming.

“Previously, we were getting 18 cents for every dollar of Medicaid service we provided,” said R-Richmond’s Barrett. “It’s been a few years…and it’s probably gotten worse.”

Barrett said many of the insurance rules proposed at the meeting will be discussed at Wednesday morning’s discussion. HB1003 Set to start at 8:30 a.m. on the House Insurance Committee

Other items on the invoice

The bill also includes provisions to encourage independent practice by giving doctors unaffiliated with the larger health care system a $1,000 tax credit for several years, which will increase competition, Schaibley said. said. Additionally, only Critical Access hospitals are allowed to include non-compete clauses in their contracts with physicians. This is also a concept under consideration. in the Senate.

Both chambers of commerce have introduced bills surrounding site-of-service language. This allows large healthcare systems to bill insurance as if the procedure took place in a hospital or larger facility rather than an off-campus building. A much more expensive setup. as a clinic.

“If you’re a hospital, it’s more economical to have an outpatient department to provide services than an independent clinic,” said Gloria Satchdev, president and CEO of the Indiana Employers Forum. increase.

Tabor called the language “restrictive” in his testimony, but didn’t elaborate on it during Tuesday’s testimony.

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