More than three years out from the end of the Great Recession, the economy's weak and fitful recovery has continued to deliver disappointing job growth. Hospitals have reported fewer patients and more uninsured since the recession, which stripped some households of health insurance as the economy shed jobs.
But here's some news that may be welcomed by hospitals. Newly released Census Bureau figures show that an erosion in employer-sponsored insurance, which accelerated during the downturn, halted in 2011.
Unsurprisingly, the percentage of people with health insurance through an employer dropped sharply in 2009 (56.1% from 58.9% the prior year) and continued to slide in 2010 to 55.3%. But last year's 55.1% was not a significant difference from the year before, the Census Bureau said. You can read more on the Census Bureau figures in this week's Modern Healthcare.
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Hospitals increasingly ask patients to pay a medical bill when they arrive or before they leave. Here's a look at how one Minnesota hospital went too far to collect bills and violated Medicare rules and a law that safeguards access to emergency medical care, regardless of ability to pay.
The University of Minnesota Medical Center, one of seven hospitals owned by Fairview Health Services, is facing a full audit of its compliance with Medicare rules and a follow-up inspection of how well it adheres to the Emergency Medical Treatment and Labor Act, which says hospitals must hold off any talk of payment until a patient has been examined and stabilized.
Collection efforts at Fairview hospitals came under public scrutiny this year after an inquiry by Minnesota's attorney general into Accretive Health, the healthcare billing and collection company Fairview hired. Accretive, based in Chicago, reached a settlement with the attorney general in July that barred the company from Minnesota for at least two years. Accretive denied any wrongdoing.
Nonetheless, an investigation into the University of Minnesota Medical Center found that hospital bill collectors harassed patients and violated EMTALA.
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The first two years of a Sacramento accountable care experiment cut spending by $50 million, including $13 million that was divided by the participating doctors, hospitals and insurer.
But in year three, those savings have grown more elusive. That's according to Kristen Miranda, vice president of provider network management at Blue Shield of California, which launched the project with Dignity Health, formerly Catholic Healthcare West, and Hill Physicians Medical Group. “It does get harder,” said Miranda.
The partners were scheduled to meet last week to review new strategies for further savings, such as development of patient-centered medical homes, she said.
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Hospitals beware. Your customers may soon be comparison shopping, if they aren't already.
Hospital prices vary, sometimes widely, and some employers have started to test ways to drive patients toward quality hospitals that charge less than their competitors.
In California, Oregon and Texas, the push to encourage consumers to shop for value has underscored some stark price differences and employers' increasing unwillingness to pay more with no discernible benefit, researchers report in the latest issue of Health Affairs.
Indeed, the California Public Employees Retirement System and grocery chain Safeway have left the choice—and the cost—of selecting a pricey hospital or doctor to households.
The cost can be considerable, reports James Robinson, a professor of health economics at the University of California at Berkeley, and Kimberly MacPherson, the university's health policy and management program director.
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