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HHS Releases Ownership Data on All Medicare-Certified Hospitals

12/24/2022

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Releasing ownership data on Medicare-certified hospitals will boost healthcare transparency and promote competition, HHS says. By Jacqueline LaPointe
December 21, 2022 - HHS is releasing ownership data on all Medicare-certified hospitals in a bid to promote competition in a highly consolidated industry.
“At President Biden’s direction, this Administration puts consumers first – and we believe consumers deserve transparency,” HHS Secretary Xavier Becerra said in a recent announcement. “At HHS, we continue taking unprecedented action to deliver on President Biden’s vision. We are pulling back the curtain and letting the sunshine in on hospital and nursing home ownership because it is what the public deserves.”
“As we work to expand access to high-quality, affordable [healthcare], we will make sure there is transparency to ensure that facilities are held accountable and people can make the best-informed decisions on their care.”
Dig Deeper
  • Experts Predict Strong Merger and Acquisition Activity for 2023
  • Biden’s EO on US Competition Will Impact Hospital Mergers
  • Increase in Cross-Market Hospital Systems May Hurt Market Competition

Detailed information on the ownership of more than 7,000 hospitals will be available for the public to view on CMS’ website. The information includes enrollment information, such as organization name, type, practice location addresses (e.g., off campus), National Provider Identifier (NPI), CMS Certification Number (CCN); detailed information about each owner, such as whether it is an organization or an individual and whether it is a direct owner or indirect owner (that is, there is at least one subsidiary between it and the provider); and a numerical associate ID for each owner to enable linkage to the enrollment file.
Making hospital ownership data publicly available will benefit researchers, enforcement agencies, and patients, according to HHS.
Researchers and other agencies will be able to use the data to identify common owners that have had histories of poor performance, for example. The federal department also said the information could be used to analyze data and trends on how market consolidation impacts consumers with increased costs, without necessarily improving quality of care, and to evaluate the relationships between ownership and changes in healthcare costs and outcomes.
HHS also plans to analyze the data to inform policy approaches that promote competition in healthcare.
Healthcare is a heavily consolidated industry as more organizations combine to achieve economies of scale and tap into greater innovation. However, industry stakeholders have criticized healthcare consolidation, saying it leads to less competition and higher prices for consumers. Patients may also face fewer options for healthcare services in concentrated markets, thereby limiting access to affordable care for consumers.
The American Hospital Association (AHA), however, has stood its ground in asserting that mergers and acquisitions help reduce hospital costs.
In 2021, AHA updated its analysis of hospital transactions and found that mergers and acquisitions were associated with a 3.3 percent reduction in operating expenses between 2009 and 2019. Based on this figure, acquired hospitals could save $9.5 million each year.
Although, research has shown that these deals do not improve quality and may even make it worse in some communities.
HHS has committed to increasing transparency in healthcare in an effort to promote competition. With greater competition, the federal department hopes to reduce healthcare costs for consumers without impacting the quality of care they receive.
HHS also said releasing hospital ownership data will allow patients to make more informed choices when it comes to selecting a healthcare provider.
CMS is expected to update the data on a monthly basis and provide it in a searchable format on data.cms.gov. Hospital ownership data will also be available in a flat Excel file.

​https://revcycleintelligence.com/news/hhs-releases-ownership-data-on-all-medicare-certified-hospitals
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Medical Bills Are Confusing for Nearly 40% of Adults, Survey Finds

12/24/2022

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Respondents said that getting a call from their provider before receiving care that explains payment expectations and financial assistance options would help them understand their medical bills better.
 By Victoria Bailey
December 19, 2022 - Almost 40 percent of Americans are confused by their medical bills, with many feeling uncertain about what they are being billed for or if they will be able to pay, according to a survey conducted by YouGov on behalf of healthcare operations company AKASA.
The survey reflects responses from 2,026 adults 18 years and older, gathered between March 9 and March 14, 2022.
Respondents were asked to rate how confusing medical bills are to understand on a scale from one to five, with one indicating not confusing at all and five being extremely confusing.
Eleven percent of participants found medical bills not confusing at all, 14 percent leaned toward medical bills not being confusing, and 37 percent were neutral on the confusion of medical bills.
Meanwhile, a combined 38 percent of respondents found medical bills either somewhat or extremely confusing.
The survey also asked respondents to rank their frustrations surrounding the financial experience after receiving healthcare services. The top concern was understanding what they were being billed for, with 29 percent of individuals citing this frustration. Twenty-seven percent of respondents said they were most concerned about their ability to pay the bill.
Nearly a quarter of adults were frustrated about not getting a medical bill until weeks after receiving care, while 20 percent were uncertain if their final bill would be consistent with the estimate.
“The rise of high-deductible health plans, the uncertainty of what’s being billed, the complexities of in- and out-of-network charges, and how much patients are on the hook for makes understanding and managing medical bills challenging for many families,” Amy Raymond, vice president of revenue cycle operations at AKASA, said in the press release. “Additionally, as errors in medical bills persist, patients should be diligent in reviewing their bills to ensure they’re getting an accurate bill.”
Respondents were also asked which actions would help them best understand how much they are expected to pay for healthcare.
Almost 3 in 10 (27 percent) said a call before the procedure from the physician’s office or hospital staff that walked them through payment plan options and payment expectations would help. Twelve percent of individuals said an online calculator to help determine cost ranges for services would help, while 11 percent would benefit from an email from the insurance company breaking down the bill after receiving care.
A smaller share of respondents said they would benefit from a call from the insurance company (9 percent), access to live online customer service through their health plan’s website (9 percent), or a call from the physician’s office to discuss their medical bill after receiving care (8 percent).
Past data has found that enrollment in high-deductible health plans, low income levels, and uninsurance were linked to a greater likelihood of medical bill problems. For example, 20 percent of adults enrolled in plans with a deductible of $3,000 or more reported facing issues with paying medical bills compared to 12.3 percent of adults with no deductibles.
Financial assistance programs, such as payment plans, offered by healthcare providers can help patients understand and manage their medical bills. However, 64 percent of consumers said they didn’t know if their physicians or hospitals offered these resources, according to a separate survey conducted by YouGov.

​https://revcycleintelligence.com/news/medical-bills-are-confusing-for-nearly-40-of-adults-survey-finds

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