private equity and surprise medical billing

This article from Center for Economic and Policy Research (I admit I don’t know much about this organization) claims that private equity firms have bought up medical practices and intentionally insert out-of-network doctors into teams treating you at your in-network hospital. Members of Congress have introduced legislation to curb this, but the financial lobby has been too powerful to beat.

Private equity-owned physician staffing firms grow by buying up many small specialty practices and “rolling them up” into umbrella organizations that serve health care systems across the United States. KKR-owned Envision Healthcare with 69,300 employees, and Blackstone-owned TeamHealth with 20,000 employees, dominate the market for outsourced doctors’ practices. A team of Yale University health economists examined what happened when private equity-owned companies EmCare (part of Envision Healthcare) and TeamHealth took over hospital emergency departments.5 They found that when EmCare took over the management of emergency departments, it nearly doubled its charges for caring for patients compared to the charges billed by previous physician groups. The researchers also found that TeamHealth took a somewhat different tack. It used the threat of sending high out-of-network surprise bills for ER doctors’ services to an insurance company’s covered patients in order to gain high fees from insurance companies as in-network doctors.6 This avoids the situation where a patient gets stuck with a large, surprise medical bill, but it raises premium costs for everyone. In both cases, healthcare costs increase when outsourced emergency rooms and other physician services are owned by private equity firms.

My take: Campaign finance reform and Medicare for All, baby!

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