Becker's Hospital Review

36 CFO / FINANCE US health spending estimated to reach nearly $6 trillion in 8 years By Kelly Gooch N ational health spending is projected to grow 5.5 percent on average annually and reach nearly $6 trillion by 2027, accord- ing to federal estimates published in Health Affairs. The estimates come from a report by the CMS Office of the Actuary. Five other findings from the report: 1. National health spending will represent 19.4 percent of gross do- mestic product in 2027, compared to 17.9 percent in 2017. 2. Federal government officials largely attribute the national health spending growth from 2018 to 2027 to economic factors, such as growth in income and employment, and demographic factors, such as baby boomers continuing to transition from private insurance into Medicare. 3. Prices for healthcare goods and services are projected to grow 2.5 percent on average annually for 2018 to 2027, up from 1.1 percent from 2014 to 2017. 4. Average annual spending growth in Medicare (7.4 percent) is ex- pected to surpass Medicaid (5.5 percent) and private health insurance (4.8 percent) from 2018 to 2027. Federal officials said this is mostly due to comparatively higher projected enrollment growth. 5. The insured share of the population is expected to stay at about 90 percent through 2027. n Why 2 hospitals are slashing medical bills by 50% By Ayla Ellison O hio Valley Medical Center in Wheeling, W.Va., and East Ohio Regional Hospital in Martins Ferry, are allowing patients with outstanding medical bills to pay only half of their balance, according to The Intelligencer. Under the limited-time offer, if a patient pays half of a medical bill from 2018 or earlier, the hospitals will write off the remaining half of the bill. The hospitals have received a lot of positive feedback from patients who were happy their medical debt was reduced by half. Officials said the offer has helped the hospitals collect on overdue accounts. "It's a really good way to collect on old ac- counts," Jose Guevara, the hospitals' revenue cycle director, told The Intelligencer. The offer was slated to end Feb. 28, but the hospitals extend it until mid-March. n Zuckerberg hospital considers cost cap for privately insured patients amid billing uproar By Kelly Gooch P rivately insured patients receiving emer- gency services at Zuckerberg San Fran- cisco General Hospital could see a cap on out-of-pocket payments, according to a San Francisco Examiner report. A cap is under consideration by San Francis- co health officials amid a public spotlight on the hospital's practice of balance billing. Balance billing occurs when privately insured patients receive trauma or emergency ser- vices from an out-of-network provider and are billed for the balance aer the insurance company pays its portion. Zuckerberg San Francisco General — re- named aer Facebook founder Mark Zuck- erberg and his wife Priscilla Chan, MD, do- nated $75 million to the hospital — is San Francisco's largest public hospital and houses a level 1 trauma center. Although the hospital primarily treats Medi- care, Medicaid and uninsured patients, it has been in the news since a recent Vox Media report revealed the hospital is out of network with all private health plans, which can leave patients with massive bills. Balance billing is lawful in California for pa- tients with preferred provider organization health plans, and as many as 1,700 privately insured patients incur significant out-of-pock- et costs annually at Zuckerberg hospital, ac- cording to the San Francisco Examiner, which cites information reported Feb. 21 by the San Francisco Department of Public Health during a board of supervisors committee hearing. "What we are proposing is to set a new policy that will limit the total amount that the [pri- vately insured] patient has to pay based on a policy that takes into account the patient's income," said Greg Wagner, CFO of the city's health department. "Instead of the patient paying that whole bal- ance, there would be a limit on how much we would bill the patient for care at Zuckerberg San Francisco General Hospital," said Mr. Wagner. e San Francisco Examiner reported that San Francisco health officials are also looking at improving communications with patients about medical bills as well as overhauling procedures to assess whether a patient qual- ifies for financial support programs before billing the patient. e proposals come aer the hospital an- nounced Feb. 1 that it would be halting bal- ance billing for 90 days to finalize a plan to address billing issues in the long term. Mr. Wagner said the cap proposal is a short- term solution and that hospital and public health leaders will also consider long-term policy changes. n

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