New doctors’ organization seeks hospital bill transparency

by Andy Marso, KHI News Service

A newly formed group of independent Kansas physicians is asking legislators to require hospitals to provide more information about facility fees on their bills.

Elizabeth Rowe, executive director of the Kansas Independent Physicians, said Tuesday that Senate Bill 122 could help health care consumers find outpatient services at cheaper rates than if they’re provided in a hospital.

Rowe said hospitals and doctor’s offices used to provide different medical services, but now more doctor’s offices are owned by and housed within hospitals and offer the same outpatient services like MRIs or spinal taps.

“Now the hospitals are doing the exact same services and competing with doctors, but they get paid more — a lot more,” Rowe said.

Dana Winegarner, a neurologist from the Rowe Neurology Institute in Lenexa, presented the Senate Public Health and Welfare Committee with billing information that showed a brain MRI costing twice as much at several Johnson County hospitals as it does at his clinic.

“Where is all that extra money going?” Winegarner asked, rhetorically.

He said some of it goes to hospital administrators and shareholders. If consumers see that broken down in their bills, they might choose outpatient care in other settings, he said.

Rowe said the Kansas bill is modeled off a law Connecticut passed last year.

Tish Hollingsworth, vice president of reimbursement for the Kansas Hospital Association, spoke against the bill Tuesday.

Hollingsworth said the state’s hospitals are required to disclose billing information to government officials to participate in public health care programs like Medicare and Medicaid.

Hospitals already deal with several different payer models in the private insurance market and government plans run by contractors, and she said SB 122 would present another administrative burden that would increase costs.

Citing hospitals’ raw prices is misleading, she said, because most of the facilities are required to treat everyone who comes through the doors and they rarely recoup the full charge after negotiating with insurance companies.

“While our charge may be high, depending on our payer mix, we’re not getting reimbursed anywhere near what our charge may be,” Hollingsworth said. “However, we have to set our charges at a rate that at least covers our costs involved to do these services based on the payer mix we have within our facilities.”

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