August 15, 2019 | Study confirms surprise billing crisis

August 15, 2019


Best and worst

To determine where Americans receive the best and worst health care, WalletHub compared the 50 states and the District of Columbia across 43 measures of cost, accessibility and outcome. Minnesota topped the list followed by Massachusetts, Rhode Island, District of Columbia and Vermont. Alaska came in at the bottom, with North Carolina, Mississippi, South Carolina and Arkansas filling out the bottom five slots. WalletHub crunched the numbers a variety of ways, and an interactive chart allows users to do the same. (WalletHub)

No surprise: Study confirms surprise billing crisis

Research released Monday confirms that “surprise” billing is on the rise among patients with private insurance. The incidence of out-of-network billing at in-network hospitals increased between 2010 and 2016, from 32.3% to 42.8% of emergency department visits and from 26.3% to 42.0% of inpatient admissions. “Moreover, the potential financial consequences of out-of-network billing in both settings nearly doubled during this period, and the top 10% of patients faced liabilities of more than $1000 for ED visits and more than $3000 for inpatient care,” the authors conclude. An accompanying editorial calls for an end to surprise billing. (JAMA Internal Medicine; editorial)


Sepsis control starts in the ambulance

Implementing a sepsis screening tool for emergency medical services to use helps expedite care, according to research published in theAmerican Journal of Emergency Medicine. Sepsis screening during EMS transport nearly doubled adherence to the standard-of-care treatment bundle. Coauthor Megan Rech, PharmD, MS, described the protocol to HealthLeaders. "We implemented a standard operating procedure for sepsis screening—seven questions for the emergency department RN to ask EMS in any adult patients excluding trauma. When sepsis was suspected, the radio RN would notify the charge nurse to help get them into a room.” (HealthLeaders; American Journal of Emergency Medicine)

Selling the rural experience

A handful of medical school across the country have programs dedicated to bolstering the number of primary care doctors in rural communities. They organize outings and cultural experiences designed to sell students on living in these communities after they graduate. Schools have taken students whitewater rafting and skiing, brought in an Appalachian storyteller and catered local delicacies. “It’s a little sense of what the fun part of rural life can be,” Dr. Dana King, chair of the family medicine department at West Virginia University School of Medicine, tells the Associated Press. (AP)


Patients aren’t behaving like consumers

Among patients who had a planned visit to the hospital in the past year, only 12% price-shopped ahead of time, according to a survey of 1,000 patients conducted by Waystar. Only 28% discussed costs with staff or got an out-of-pocket estimate. Among the 88% who didn’t price shop, 38% said they didn’t know prices varied by hospital. About a quarter (24%) thought the pricing was too complicated, and 23% said they didn’t know how to comparison shop. (Healthcare Dive; survey)

Capping insulin costs

Nonprofit health insurer Medica is capping the cost of insulin at $25/month, but for now, that policy applies only to Minnesota patients. The cap goes into effect Jan. 1, 2020. This comes on the heels of the Minnesota Legislature’s failed attempt to provide emergency access to diabetics who need insulin to survive. (St. Paul Pioneer Press)


The cost of care: It appears that overwhelming medical bills played a key role in an apparent murder-suicide in Washington state. A couple left notes indicating they were worried they couldn’t afford treatment for the wife’s severe medical issues. (USA Today)

Rural communications upgrade? The Federal Communications Commission recently introduced reforms to the Rural Health Care Program intended to make it easier for hospitals and other medical providers in remote areas to receive access to broadband and telecommunications services. But not all the commissioners are on board. (mHealth Intelligence)

The more you know: Genetic testing appears to motivate behavioral changes in families with risks of developing melanoma, according to research published in Nature: Genetics in Medicine. (Nature: Genetics in Medicine)


AAP: Racism hurts children’s health

The American Academy of Pediatrics released its first-ever policy statement on the impact of racism on children. The statement draws from hundreds of studies to warn doctors that exposure to racism is harming children’s overall health. NPR's Michel Martin speaks with one of the co-authors. (NPR; statement)


“They think it’s the only way out. That just shouldn’t be in this country. There should be a much better way of responding to that.” —Whatcom County Sheriff Bill Elfo to USA Today, discussing the murder/suicide apparently driven by angst over medical bills.

Jorden Gunessever