- Mothers who received a surprise medical bill after delivery were more likely to switch hospitals for their second delivery than mothers who did not get an unexpected charge, according a new study in Health Affairs.
- A review of 2007-2014 medical claims for obstetric patients who had two deliveries while covered by employer-sponsored plans found that 11% got a surprise bill, increasing their likelihood of switching hospitals for the next delivery by 13%.
- Those who did switch had their chances of getting a surprise bill for the second delivery reduced by more than half.
Surprise billing is most associated with emergency room visits, but this study illustrates that even when a patient has the chance to choose where they receive care, an expensive bill can catch them off guard — usually the result of an out-of-network provider at an in-network facility.
The results "highlight the harmful effects" of surprise bills, the report authors wrote. "Patients would benefit significantly from laws protecting them from the damaging financial consequences of surprise out-of-network bills, including those incurred in elective situations."
The practice of surprise billing has come under increased scrutiny from lawmakers at the state and federal level.
Lawmakers in both parties on Capitol Hill have voiced support for such efforts, and one Republican Senator said he hopes to file a bill by the end of March.
Hospital groups have expressed support for a legislative ban, but argued in a letter to lawmakers last month it should not include any fixed payment amount or reimbursement methodology. The American College of Emergency Physicians agrees. The group's president, Vidor Friedman, told reporters earlier this year he believes "using market forces is a better way to do it at this point."
Public pressure for some action isn't likely to abate, especially as healthcare remains a key topic for 2020 presidential contenders. About four in 10 people said they have experienced a surprisingly high medical bill in the past year and 38% were "very worried" about being able to afford one, according to a recent Kaiser Family Foundation study.
The latest Health Affairs report shows that hospitals can be hit with public relations damage when a patient gets a surprise bill, Loren Adler, associate director of the USC-Brookings Schaeffer Initiative for Health Policy, said on Twitter.
(1) Transparency might somewhat reduce surprise billing, but if it does so by increasing the reputational harm to insurers and/or hospitals when it occurs, that'll raise the cost of ED & ancillary physician services even farther above normal mrkt rates & flow through to premiums.— Loren Adler (@LorenAdler) March 4, 2019