Americans Deserve a Fair Deal on Healthcare – Inside Sources

Employers are the largest source of health coverage for Americans, protecting families and their ability to make a living. They’re doing everything right — investing time and energy to ensure Americans can access the care they need. However, healthcare prices are rising so fast that the families they’re trying to protect still face obstacles to care, and employers struggle to make affordable healthcare plans work.

The No. 1 source of these rising prices? Corporate hospital systems.

As hospital prices soar, companies bear these inflated costs directly or indirectly through rising premiums. Employers are forced to reduce health benefits or allocate more from employee paychecks just to keep families covered. In either case, their ability to attract and maintain employees is weakened, and their long-term stability is threatened.

Corporate hospital systems’ predatory pricing practices and anti-competitive tactics are driving this. In recent years, half of the country’s metropolitan areas saw one or two corporate hospital systems dominate their markets.

The result? Less competition and greater market concentration. When corporate hospitals negotiate with purchasers, their local dominance becomes a powerful source of leverage. If insurance companies refuse to give in to their demands for higher prices, monopoly hospitals threaten to cut them out of network. Employers’ hands are tied.

Hospital prices are rising faster than inflation, wages and nearly every other part of the healthcare system. After a physician’s office is acquired by a hospital system, prices jump by an average of 14 percent. As long as these pricing tactics remain unchecked, employers and patients will continue to lose purchasing power.

Yet these higher prices don’t translate to better care. When hospital systems acquire physician practices, they impose facility fees and site-of-care charges. Patients end up paying more for the same care simply because the hospital’s name is now on the building. What’s more, many hospital monopolies have closed entire units or locations they deem unprofitable. As a result, healthcare becomes financially and physically inaccessible for patients.

Patients need their voice back. So do the purchasers fighting to protect their access to high-quality healthcare they can afford. However, corporate hospital price hikes put families’ health in jeopardy, along with the communities they support, the industries they contribute to, and America’s broader economic prosperity.

Congress has taken steps in the right direction, but more action is needed to hold hospitals accountable and truly address our country’s healthcare affordability crisis.

Transparency is essential to break this cycle. Hospital systems mislead patients with inaccurate price estimators, hidden facility fees and deliberately complicated billing codes. Patients don’t know what they’ll pay, and employers can’t get accurate cost information. Stronger hospital billing transparency and site-neutral payments for Medicare patients aren’t policy fixes — they’re necessary to challenge these deceptive pricing practices.

Increased transparency won’t be enough as long as monopoly hospitals continue to dominate the healthcare landscape. We need to do more to promote competition and restore purchasing power to patients and employers.

One critical step is banning anti-competitive billing practices. A recently introduced bill in the Senate would ban anticompetitive clauses in contracts between payers, healthcare providers and hospitals. These restrictive contracting practices suppress competition while driving up premiums and out-of-pocket costs for patients. Tackling these market abuses head-on is the clearest path to meaningful reform.

While employers and purchasers work hard to offer their employees high-quality, affordable care, large hospital systems have capitalized on every opportunity to make a profit. In our fight to resolve the healthcare affordability crisis, we must restore power to those fighting to keep working Americans healthy.