Montana officials looking into hospitals' defense of healthcare prices

Montana officials are questioning healthcare prices in the state after recent research shed light on how much hospitals charge, according to the Bozeman Daily Chronicle.

A RAND Corp. study done in collaboration with the Employers' Forum of Indiana — which examined prices from 1,598 hospitals across 25 states — found that private insurers, on average, paid hospitals 241 percent more than Medicare rates for services provided to members in 2017. According to the Chronicle, the study found that in Montana, these prices can be two-to-four times higher than what Medicare pays for care provided to privately insured patients.

Given these findings, as well as other findings by the state auditor's office, Montana officials are looking into the issue.

"People are unable to afford care and they're also very cognizant that the hospitals keep getting bigger and fancier," Deputy State Auditor Kris Hansen said Sept. 18 during the annual Montana Insurance Summit, according to the Chronicle. "There's a disparity there and nobody's explaining it to them."

Hospital officials have defended healthcare prices, saying they rely on reimbursement from private insurers to offset lower reimbursement from government payers like Medicare, the newspaper reported.

According to the Chronicle, Marilyn Bartlett, special projects coordinator for the Commissioner of Securities and Insurance, said the office is continuing to question healthcare prices and that an updated federal accounting standard will show more information about hospitals' prices and overall profit margins differ. 

The forthcoming information could help shape future legislative proposals in the state.


More articles on healthcare finance: 

Vermont hospitals expected to see nearly $3B in revenue under 2020 budgets
House committee calls off plans for surprise-billing vote
CPT code changes in 2020: What hospital revenue cycle staff should know before Jan. 1

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