|
 Researchers focused on so-called chargemaster rates, or sticker
prices, for two services that are often the source of surprise
medical bills for patients - emergency medicine and anesthesiology.
Patients with insurance usually pay only a small fraction of
chargemaster rates, but people who lack insurance or receive care
from out-of-network physicians may be billed at these higher rates.
Researchers examined Medicare claims data from 2012 to 2016 for
emergency medicine and anesthesiology, focusing on the difference
between Medicare reimbursement rates and chargemaster rates.
Adjusted annual increases in chargemaster prices were 28% in
emergency medicine and 32% in anesthesiology, the study found.
"These findings are particularly worrisome given that the incidence
of emergency department surprise medical bills increased from 32% to
43% between 2010 and 2016, leading to greater patient financial
liability," Dr. Tim Xu of Johns Hopkins University School of
Medicine in Baltimore and colleagues write in JAMA Internal
Medicine.
"Patients can face legal action and wage garnishments if they are
unable to pay these excessive prices," Xu and colleagues write.
The analysis included 2,042 hospitals from all 50 U.S. states.
Overall, 18% were for-profit hospitals; 20% of the hospitals in the
study had a high proportion of uninsured patients.
In 2014, chargemaster rates for emergency medicine were 3.9 times
higher than Medicare rates. By the end of the study they were 5.1
times higher than Medicare rates.
For anesthesiology, chargemaster rates were 6.1 times higher than
Medicare rates at the start of the study and 7.4 times higher by the
end.
[to top of second column] |
By comparison, chargemaster rates for general internal medicine care
started out at 2.1 times higher than Medicare rates and ended up 2.4
times higher. This translated into an annual adjusted growth rate of
7%.
These findings build on prior research showing that hospital
chargemaster prices, specifically the "markups" greater than
Medicare reimbursement rates in medical bills for out-of-network
care, vary widely across hospitals and even within hospitals, the
study team notes.
One limitation of the study is that researchers only had data on the
chargemaster rates, whereas patients may have paid less than these
rates in some cases.
Another drawback of the study is that it focused on physician fees,
not on any facility fees that might generate separate surprise
medical bills for patients.
Even so, the study offers fresh evidence that patients' surprise
medical bills may be getting pricier as they become more common, the
authors conclude.
Patients who are already most vulnerable to the economic toll of
surprise bills may also be most likely to receive them, the results
suggest.
The study found that emergency departments serving a higher
percentage of uninsured patients raised their charges more, a
potential sign of cost shifting under financial stress.
SOURCE: http://bit.ly/2Qab2V4 JAMA Internal Medicine, online
November 11, 2019.
[© 2019 Thomson Reuters. All rights
reserved.] Copyright 2019 Reuters. All rights reserved. This material may not be published,
broadcast, rewritten or redistributed.
Thompson Reuters is solely responsible for this content. |
