The biggest trend in healthcare finance was renewed pressure on providers and other healthcare stakeholders to address the issue of healthcare affordability. The hallmark of these efforts involved federal government proposals to address price transparency and surprise billing, but the attention on prices and affordability seemingly came from all directions in 2019.
Year in Review: Deepening scrutiny on affordability is 2019's biggest trend in finance
Big 3
Merger complete: Catholic Health Initiatives and Dignity Health merged to form CommonSpirit Health, which posted a $602 million operating loss on $21 billion in operating revenue in its first annual financial report as a merged system.
On its own: After nearly two years of attempting to sell its revenue-cycle subsidiary, Tenet Healthcare Corp. spun off Conifer Health Solutions as a separate, publicly traded company. Healthcare analysts said the move allows Conifer to spend money in a way that’s best for the company and not its larger parent company.
Class action settlement: Sutter Health reached a tentative settlement in a class action lawsuit alleging it engaged in anticompetitive contracting practices. Health plan plaintiffs had sought $900 million in damages.
The focus on prices prompted unique responses, especially in Summit County, Colo., where a group of large and small businesses and individuals banded together to negotiate prices for healthcare services directly with providers and shop those rates to insurers. Despite all the attention, providers, payers and other stakeholders still tended to deflect when asked about their role in lowering prices.
One integrated health system, Salt Lake City-based Intermountain Healthcare, is unique in its outspokenness about lowering prices. The health system says it has 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-for-profit health systems routinely file against patients. One system—Ballad Health, based in Johnson City, Tenn.—filed 5,700 lawsuits and 900 liens in its first fiscal year as a newly merged health system.
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