Scrutiny grows over hospital billing practices for routine care
- Reports
- 2
- Developments
- 2
- Repetition
- 0%
New informationRepeats or wire copies
What happened
Research shows that as U.S. hospitals purchase doctor's offices, routine medical care is frequently billed at the higher rate for hospital care instead of the lower rate for office procedures. These higher rates, along with facility fees, can lead to bills that are ten times costlier or more. The Blue Cross Blue Shield Association estimates that hospitals could bill $500 billion less over the next decade if they were federally banned from charging higher rates for the same service.
From adn.com
Why it matters
The practice of charging hospital rates for routine care is under review by insurers and lawmakers. Hospital systems justify these higher charges by stating they are necessary to subsidize complex hospital care, but limiting these fees could potentially lead to reductions in services.
From adn.com
Who's involved
- Blue Cross Blue Shield AssociationFederation of health insurance organizations raising concerns about billing practices
- American Hospital AssociationHealth care industry trade group whose revenue models are potentially threatened by rate caps
- MedicareUS federal health insurance system facing financial risk from overcharging
- ChalkerSenior vice president at the Blue Cross Blue Shield Association
- Arkansas Insurance DepartmentGovernment agency that provides regulatory oversight for Blue Cross Blue Shield Association
Who could feel it
Possible knock-on effectsThese are possibilities Brind reasoned out, not predictions, and not advice. Most are not stated in any report.
- American Hospital AssociationSpeculative
The American Hospital Association could face reduced revenue if federal bans limit the ability to charge higher rates for services.
Possible ripples
Who this could reach next, traced step by step from the reporting. Possibilities worth considering, not forecasts.- Systemic hospital overcharging may increase financial risk for MedicareSystemic hospital overcharging could increase financial risk for MedicarePossible
- Potential federal bans on high billing rates could reduce hospital revenue and servicesPotential federal bans on high billing rates could reduce hospital revenue and services.Possible
How it developed
Newest first. Tap a step to see who reported it.Hospitals are engaging in acquisitions of doctors' offices across the US.1 source
General statement confirming BCBS's role in US healthcare coverage.1 source
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The entities involved
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Blue Cross Blue Shield Association
federation of 36 separate United States health insurance organizations and companies
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