Big bills, big prob­lems

Preven­tion and cost-cut­ting would be help­ful pre­scrip­tions

Modern Healthcare - - OPINIONS EDITORIALS - NEIL MCLAUGH­LIN Man­ag­ing Ed­i­tor

Notes on the news: The Ac­cre­tive Health saga took an­other turn last week as the billing and col­lec­tion com­pany said it would launch and fund a panel to set pa­tient col­lec­tion stan­dards. Ac­cre­tive has taken a dip in hot water over al­le­ga­tions that it used abu­sive tac­tics in try­ing to col­lect money from pa­tients—some as they ar­rived at the hospi­tal or the emer­gency room (April 30, p. 6). The Min­nesota at­tor­ney gen­eral’s of­fice is­sued an un­com­pli­men­tary re­port about the com­pany’s prac­tices. That in­ves­ti­ga­tion stemmed from col­lec­tion ef­forts at Fairview Health Ser­vices, the Min­neapo­lis-based sys­tem that was one of Ac­cre­tive’s high-pro­file clients. Fairview ended its con­tract with Ac­cre­tive about a month ago.

Since then, U.S. law­mak­ers have taken an in­ter­est, mak­ing a sweep­ing re­quest for doc­u­ments on the com­pany’s poli­cies and prac­tices (May 7, p. 12). Rep. Pete Stark (D-calif.) has asked HHS and the CMS to in­ves­ti­gate Ac­cre­tive. And the Illi­nois at­tor­ney gen­eral has said she will ini­ti­ate a probe.

Ac­cre­tive has vig­or­ously de­nied any wrong­do­ing, say­ing al­le­ga­tions of mis­con­duct are un­founded. It also de­nies that it vi­o­lated fed­eral privacy and credit laws.

Now, the Chicago-based com­pany says it has ap­pointed a blue-rib­bon panel to se­lect a not-for-profit, in­de­pen­dent stan­dard de­vel­op­ment or­ga­ni­za­tion to bring to­gether health­care or­ga­ni­za­tions, pa­tient ad­vo­cates, trade groups and oth­ers to cre­ate “vol­un­tary con­sen­sus stan­dards.” Those stan­dards will be sent to a na­tional ac­cred­i­ta­tion group, Ac­cre­tive said.

For­mer HHS Sec­re­tary Mike Leav­itt will chair the panel, which in­cludes for­mer CMS ad­min­is­tra­tors Dr. Mark Mcclel­lan and Donna Sha­lala as well as for­mer Sens. Tom Daschle and Bill Frist.

This ef­fort is com­mend­able, but you have to won­der if a lot of grief might have been avoided by do­ing this on the front end. Given the sen­si­tive na­ture of pa­tient col­lec­tions, shouldn’t the com­pany have adopted and com­mu­ni­cated stan­dards to its em­ploy­ees at the out­set?

And there are al­ready some guide­lines for the in­dus­try. The Amer­i­can Hospi­tal As­so­ci­a­tion has hospi­tal billing and col­lec­tion guide­lines, which were re­cently up­dated. Preven­tion is good in health­care busi­ness as well as medicine.

Speak­ing of bills, two in­ter­est­ing stud­ies were re­leased this month on costs.

Ben­e­fits con­sul­tant Mil­li­man re­ported that the av­er­age health­care bill for a fam­ily of four year has in­creased 6.9% from 2011 to $20,728 this year. The com­pany said that was the low­est an­nual in­crease in the 12 years of its sur­vey. But the dol­lar boost was the largest so far—$1,335.

So the re­sults of a new Com­mon­wealth Fund re­port ex­am­in­ing health­care spend­ing, sup­ply, uti­liza­tion and qual­ity are no sur­prise. The U.S. spends far more on health­care than any other coun­try. Why? It’s not be­cause Amer­i­cans go to the hospi­tal or the doc­tor more than peo­ple in other coun­tries—they don’t. The U.S. has fewer physi­cians per per­son than in all the study coun­tries ex­cept Ja­pan. But our hospi­tal stays were far more ex­pen­sive than those in other coun­tries— to­tal­ing more than $18,000 per dis­charge. In Swe­den, Australia, New Zealand, France and Ger­many, the cost is less than $10,000.

“It is more likely that the higher spend­ing is largely due to higher prices and per­haps be­cause of more read­ily ac­ces­si­ble tech­nol­ogy and greater rates of obe­sity,” au­thor David Squires wrote. “De­spite be­ing more ex­pen­sive, the qual­ity of health­care in the U.S. does not ap­pear to be notably su­pe­rior to other in­dus­tri­al­ized coun­tries.”

Af­ter the bat­ter­ing so many pa­tients have taken in the Great Re­ces­sion, who­ever is col­lect­ing the supersized bills faces a big chal­lenge.

Newspapers in English

Newspapers from USA

© PressReader. All rights reserved.