Perspective: Ensuring patients know what they’ll pay for care

When you enter any health care setting, there are always many things running through your mind: What’s going to happen? How long will this take? Will I be okay? You’re probably also thinking: What’s this going to cost me?
 
The last thing a patient should worry about in a health crisis is an unanticipated medical bill that unintentionally impacts their out-of-pocket costs … and undermines the trust and confidence that patients have in their caregivers.
 
Unfortunately, there are a variety of circumstances that can leave patients with unanticipated out-of-pocket costs, or “surprise bills.” For example: insurers controlling costs by relying on narrow and inadequate networks, and out-of-date provider directories that do not accurately reflect the provider status with the insurers’ contracts. Moreover, a separate issue is the increasing use of high-deductible health plans that create “surprise insurance” coverage resulting in higher expenses for patients. At the same time, underinsurance and the skyrocketing cost of prescription drugs further exacerbate the problem.
 
Hospitals and health systems are deeply concerned about the impact and are committed to finding a solution that first and foremost protects patients.
 
That’s why the AHA Board of Trustees has launched a task force that is drafting principles for addressing surprise medical billing, as well as the issue of pricing transparency. Our work is well underway, and we’ve been consulting with AHA members to ensure the recommendations we develop will help us shape a reasonable solution with policymakers. In addition, we’ve teamed up with others to produce resources to help patients avoid surprises.
 
To be clear: Patients should never forgo care because of cost, which is why hospitals and health systems provided $38.3 billion in uncompensated care in 2017. We need to keep working toward full enrollment in comprehensive coverage with adequate provider networks. And drug companies, insurers, providers and policymakers must work together to do right by patients.
 
We appreciate that this is a priority for President Trump and Congress, and America’s hospitals and health systems are committed to making health care more affordable for the patients we serve. We look forward to continuing to work with the administration and with all stakeholders to protect patients.