Biggest trend in healthcare finance: Deepening scrutiny on affordability

There was renewed pressure on providers and other stakeholders in 2019 to address the issue of healthcare affordability. The hallmark of these efforts involved federal price transparency and surprise billing proposals, but the attention came from all directions.

The focus on prices prompted unique responses, especially in Summit County, Colo., where a group of businesses and individuals banded together to negotiate prices directly with providers and shop those rates to insurers. Despite all the attention industry stakeholders still tended to deflect when asked about their role in lowering prices.

Intermountain Healthcare is unique in its outspokenness about lowering prices. The Salt Lake City-based health system says it lowered out-of-pocket prices on certain shoppable procedures. One example is a normal, vaginal delivery, with a plan available for uninsured patients that reduced the cost from about $6,000 to $4,150. Intermountain CEO Dr. Marc Harrison estimates the health system’s pricing initiatives will have saved Utah patients $35 million in 2019.

Related to that was public pushback on the high volume of lawsuits even not-forprofit health systems routinely file against patients. One system—Ballad Health, Johnson City, Tenn., filed 5,700 lawsuits and 900 liens in its first fiscal year as a merged health system.