This session, lawmakers have considered legislation to mandate changes in how hospitals are paid in contracts that have been privately negotiated with insurance companies. Some of these “site of service” proposals would even throw hospitals out of compliance with the federal government’s Medicare reimbursement rules.
Some major insurance companies and their front groups are misleading policymakers at state and federal levels by trying to rebrand long-standing policies as “dishonest billing.” What is truly dishonest are these insurance companies’ misrepresentations, which are merely deflections from their record profits during a time of great financial strain on hospitals. And the laws they want enacted would represent major intrusions into private contracts.
When doctors, pharmacists and patients raised grave safety concerns around insurance companies’ forcing a practice called “white bagging” on their customers, some concerned Hoosier lawmakers fought for oversight and guardrails. But the insurance industry fought these proposals tooth and nail, opposing even minor measures to ensure access to lifesaving drugs and to guarantee patient safety. Insurers’ message to the General Assembly was: “Butt out—this is a contractual issue.”
But now we see a thinly disguised public relations campaign emerge, where at least some insurers are pushing the Legislature to change the rules, further tipping the scale in their direction and padding their profits.
As an example, one entity promoting the “dishonest billing” falsehood is the “Health Action Network,” which calls itself a network of consumers, patients, businesses, providers and neighbors across the United States. I suppose, in a sense, this entity is a sort of neighbor, as its website states that, “The Health Action Network is an Anthem, Inc., initiative,” with an Indianapolis address (however, with a Washington, D.C., phone number).
In a state where the largest insurance company controls 50% to 70% of every local market, major players can already dictate how hospitals are paid without turning to the Indiana General Assembly. So why ask lawmakers to make the change for them? Because they want to avoid any opportunity for more innovative and collaborative insurers to gain market share and increase competition. If Indiana enacts site-of-service legislation, it will not only hurt hospitals and reduce access, but it will cement the stranglehold certain insurers are seeking.
Insurance companies don’t provide health care, but there should be a partnership between them and medical providers in every community to deliver the services Hoosiers need. Calling hospitals “dishonest” is a slap in the face to those who carried us through the pandemic while these giant corporations prospered.
I hope the folks behind this will step back from their shadow campaigns and join hospitals, legislative leaders and other industry stakeholders in finding collaborative solutions to reduce health care costs for Hoosiers.•
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Tabor is president of the Indiana Hospital Association.
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Hospital and Insurance used to be for critical and catastrophic care. The patient and there physician took care of the day to day check ups and minor issues. But now you have to go to a doctor that is controlled by a Hospital group and the outcome is higher cost and less interactive care. The hospital says your doctor will see 6 patients an hour and 10 minutes is all you get. And don’t even think about raising two issues while in the office, that requires another appointment.
When the doctor and the patient are removed from healthcare, and hospitals and insurance are the primary drivers. Cost go up and care goes down!
Mission control we have a problem and the two benefactor’s are the lest affected by the outcomes.