Last week, the FEHBlog attended the American Bar Association’s annual meeting in San Francisco. Here is a link to an ABA story about an opioid crisis presentation by the American Medical Association’s President-elect, Susan Bailey, MD.  Dr. Bailey encourages the FEHBlog’s profession to sue health insurers for adequate treatment coverage.

The doctor highlighted three recent legal cases that focus on opioid issues. These cases, she said, show “how legal and medical experts can work together to make sure there is evidence-based care for opioid use disorder patients in correctional settings, and that health insurance companies must use medical evidence to evaluate claims, not just financial evidence. We must work together to hold them to that standard.”

Sigh. Why can’t physicians and health plans work together on these important issues?

A UnitedHealth Group report finds that

The annual cost of hospital inpatient services for privately insured individuals exceeded $200 billion in 2018 and is projected to exceed $350 billion in 2029.1 Hospital inpatient spending growth is in luenced by several factors, including prices charged by hospital facilities (hospital prices), prices charged by physicians practicing within these hospitals (physician prices), and patients’ utilization of inpatient services

United notes that hospital prices increases materially exceed physician price increases.  United opines that “Slowing the growth of hospital inpatient costs – by reducing hospital price increases to the level of physician price increases – would make health care more a ordable for consumers and employers.” That’s easier said than done, of course. Hopefully, S. 1895, the bipartisan bill to lower healthcare costs, will help if enacted.

In the same vein, Healthcare Dive reports that

The frequency and price tags on surprise medical bills for emergency and inpatient services at in-network hospitals is on the rise, according to a study published Monday in JAMA Internal Medicine.

The percentage of emergency department visits resulting in a surprise bill jumped from 32.3% in 2010 to 42.8% in 2016 while the increase for inpatient admissions went from 26.3% to 42%. The cost of the bill in both categories nearly doubled in that time period, with the top 10% of ED visits resulting in a bill of more than $1,000, and the top 10% of inpatient visits costing more than $3,000.

Patients at some hospitals were far more likely to receive a surprise bill. For inpatient, the chance was less than 10% at about half of the nearly 3,300 hospitals included, but the chance was more than 90% at about 15% of hospitals. For ED visits, it was a greater than a 90% chance at 23% of at the more than 4,000 hospitals studied.

For this reason, the FEHBlog’s principal goal last week as he travelled through the California sub-acute care system was to avoid the emergency room.

Here’s a link to an interesting  Signal story about “8 Emerging Healthcare App Development Trends to Follow in 2019.” Check it out.