By NATALIE ROBINSON
Guest Columnist
As lawmakers work to wrap up the legislative session, there is a major opportunity to lower the astronomical cost of health care in our state.
Hoosiers have one of the highest health care costs in the country. According to data collected by the federal government on health care spending patterns of families across the nation, Hoosiers spend 32.4 percent more of their family budgets on hospitals than does the average American. State lawmakers must act quickly before time runs out to fix a billing loophole that will help lower costs.
State Senate President Rod Bray recently shared insights on this issue with members at NFIB’s Small Business Day program. He told a story about the drastic differences between what a hospital charges for a service compared to a doctor’s office. He explained that when he and his wife were both getting the exact same type of blood test, he was charged $90 for the test administered at his local doctor’s office, while his wife was charged $900 for the exact same test because it was administered at a hospital.
Now imagine being charged the higher hospital rate when you receive the same service at your doctor’s office just because it’s now owned by a hospital system. That’s the sort of thing that is happening and it’s wildly frustrating for folks. Hospitals shouldn’t be able to bill hospital prices for health care provided at facilities that aren’t on a hospital campus.
With the laws currently in place, hospital systems that own doctor’s offices, labs, and clinics are allowed to charge hospital campus rates for services provided off campus, which can be 10 times more than their actual cost. This practice is known as “dishonest billing” and it’s increasing health care costs and insurance premiums.
Small business owners want to provide their employees with health care coverage, but they just can’t afford it. According to a recent NFIB survey, the most important reason that 65 percent of small employers don’t offer health insurance is that it is too expensive. The survey found that health insurance is an expected and important benefit for many employees and small businesses compete for talent in filling job openings and retaining employees with competitive compensation packages.
However, many small businesses struggle to offer this benefit thanks to disingenuous and sneaky practices like dishonest billing that are driving up health care costs.
Another recent NFIB survey found that 60 percent of small businesses were trying to hire workers, but 90 percent couldn’t find qualified applicants. Requiring hospitals to simply bill patients for the care they receive at the accurate location the service was provided would go a long way towards lowering costs. We must address cost drivers that are hiking up rates so that small business owners can afford health care coverage for their workers, which would also help them with hiring and retention problems.
When I make a conscious decision to see my primary care doctor instead of rushing to the hospital, I expect my health care costs to reflect that. There is no justifiable reason that I should be charged higher rates for that service simply because a hospital bought out my doctor’s office. This billing loophole must be addressed, and dishonest billing practices must be stopped.
Don’t be swayed by opponents that claim charging accurate and honest rates when billing for health care services at the appropriate location will close rural hospitals because the proposed legislation addressing this issue expressly protects rural hospitals.
The ability for employees to receive and afford quality care is important. Having strong hospitals across our state is important. The two are not mutually exclusive. The good news is that there is still time for the General Assembly to prohibit dishonest billing and lower healthcare costs for Hoosier small business owners that are struggling to provide health care coverage to their employees.
To this point, I encourage state lawmakers to support legislation, which would protect Hoosiers from this unfair and dishonest billing practice that takes advantage of health care consumers.
Update: Senate Bill 6 failed to get a hearing in the House Public Health Committee this week. To lower healthcare costs, it is imperative that we get the language from SB 6 amended into HB 1004 on the floor to stop dishonest billing. This is a bipartisan issue that is also being addressed by Congress. Indiana has an opportunity to act now and make an immediate impact on lowering costs.
Federal update: Hospital outpatient billing draws bipartisan heat
Hospitals could be playing defense this year as bipartisan scrutiny builds in Congress over the way facilities charge more for outpatient services that can be done in less-expensive settings, like a private doctor’s office.
Why it matters
So-called site-neutral payment reforms could save Medicare upward of $100 billion over a decade, according to various projections, and those with private health insurance could see savings, too. But hospitals are fighting hard against the changes, saying they’re subject to more regulatory requirements and need to cover their higher expenses.
Natalie Robinson is the State Director for the National Federation of Independent Business in Indiana.