• 4 months ago
Earlier this month, Sen. Maggie Hassan (D-NH) questioned experts on the effect of the acquisition of local doctor's offices by large hospital groups during a Senate Health Education Labor and Pensions Committee hearing.

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Transcript
00:00Thank you to you, Mr. Chair, for the hearing and Ranking Member.
00:11Thank you for the hearing and thank you for your courtesy just now.
00:14Thank you to our witnesses for being here today.
00:16I really just have two questions and I want to start with Dr. Ippolito.
00:21One of the many factors driving health care costs and medical debt is unfair fees for
00:26routine care, even for Americans who have health insurance.
00:30For example, I've heard from Granite Staters who've been charged hundreds of thousands
00:34of dollars for a regular doctor's visit just because, hundreds or thousands of dollars
00:39for a regular doctor's visit just because their doctor's office has been purchased by
00:44a hospital.
00:45Dr. Ippolito, can you talk about some of the root causes that are driving these higher
00:50health care costs and unfair billing practices?
00:53We'll all stick with the example that you started with.
00:56One of the big challenges that we face right now is consolidation on the provider side,
01:00on the insurer side, throughout the system.
01:02You bring up a great example where we have a number of policies on the books that encourage
01:06lots of consolidation in the provider side and what that allows people to do is both
01:10take advantage of rules in Medicare to charge higher prices and in the commercial market
01:15charge higher prices to anybody who walks through the door.
01:17So the combination of those two things clearly contributes to high health costs and it surely
01:21contributes to medical debt.
01:23What are your suggestions about ways to curb these trends so we can protect patients from
01:27these unfair facility fees?
01:31On this side specifically, site neutral payment seems like a number one.
01:37Dr. Messack, I wanted just to touch with you on something you discuss in your testimony.
01:45Many of your patients that come into the emergency room, you say, are fearful of incurring medical
01:50debt.
01:51Can you speak to the impact of medical debt on a patient's decision to seek care, particularly
01:56early care?
01:57Absolutely.
01:58I mentioned in my testimony about a patient with late stage cancer who could have been
02:02treated early if she had showed up but feared for the costs.
02:06I also want to mention patients who come to the ED and we find that they are at risk for
02:11very serious conditions, heart attack, stroke, but we don't have that diagnosis yet and we
02:17need them to stay for more testing, just overnight, just for more testing.
02:20This conversation comes up all the time and they always ask, how much is it going to cost?
02:24I don't know the answer, but it will cost them something and oftentimes they don't stay
02:29and we don't get that diagnosis that could save their lives.
02:32I appreciate that.
02:33That's all I have.
02:34Thank you, Mr. Chair and Ranking Member Cassidy.

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