Modern Healthcare

Biggest trend in healthcare finance: Deepening scrutiny on affordabil­ity

- — Tara Bannow

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.

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