It’s Important To Know Who Owns The Hospital In Your Area

It’s funny, but before I suffered my stroke two years ago, I never gave any thought to the owner of the hospital located closest to where I lived at that time.  I remember when the hospital in every neighborhood treated you like a neighbor.  A patient was provided with the proper care needed, their insurance billed, and that was that.  There were no unpleasant surprises arriving in the mail post-discharge, such as a balance due for thousands of dollars.  I have since learned things are a lot — and I mean A LOT — different today.

I’ve learned most hospitals nationwide are owned by a select group of corporations.  Within the next 12 years, most of the hospitals in our country will be owned by just a handful of them.  Instead of treating patients like residents of the communities where hospitals are located — and there are troubling signs of this already — patients are often being treated like consumers.  Consumers off of whom hospitals owned by corporations intend to make a profit.  I am fortunate because my primary medical insurance coverage is through Medicare.  Medicare is accepted by virtually all hospitals, and despite what those hospitals bill, Congress supervises what is considered a reasonable cost and hospitals must accept that reasonable cost assessment as payment in full.  It’s also referred to as accepting assignment.

Unfortunately, Congress does not supervise the fees hospitals bill to consumers with private health plans.  The Affordable Care Act will make lower-priced insurance policies more available to those currently without insurance, but the fees billed to those policyholders’ insurance carriers by hospitals are not anything Congress will direct its attention to as is done with Medicare.  A big part of the reason is a powerful lobby called the American Hospital Association lobbies Congress with a well-funded passion.  Just as it’s important to understand what corporation (with highly paid executives) may very well own your neighborhood hospital, it’s vital as a healthcare consumer to understand what type of fee acceptance arrangement exists between your hospital’s billing department and the insurance company negotiating what is considered a reasonable fee, a fee the hospital will accept as payment in full.

I’m scratching only the surface of such important issues.  The answers are not easy to find because, in an era that is embracing universal health coverage for all (a noble idea) so few understand by having medical insurance doesn’t necessarily mean your medical bill will reflect charges as affordable as your policy premiums.

Much of this information is too complicated for me to understand, as I suspect is the case with most people.  There are a couple of simple things I do understand, though.  One is know who owns your local hospital and what that owner’s history is.  The other is to study up and learn what doctors and hospitals accept your particular medical insurance coverage.  Learn what type of arrangement exists in relation to your local hospital’s billing rates and your insurance company’s negotiated rate with that hospital and what it will accept as payment in full.

Too confusing?  It is.  Consider enlisting the help of a patient advocate who specializes in medical billing if you run into trouble.  It could save you thousands, which seems only fair during a time where a lot of medical insurers and providers are making record profits, yet many medical consumers find themselves having to declare personal bankruptcy.  This isn’t the world I was born into in 1912, but for better or for worse, it’s my world now.  And yours.  Get informed now, before you need to make a medical claim.

 

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