In Texas, a growing number of patients are turning to a little-known state mediation program to deal with unexpected hospital bills.
In Texas, a growing number of patients are turning to a little-known state mediation program to deal with unexpected hospital bills.
The bills in question often arrive in patients’ mailboxes with shocking balances that run into the tens or even hundreds of thousands of dollars.
When patients, through no fault of their own, are treated outside their insurers’ network of hospitals, the result can be a surprise bill. Other times, insurers won’t agree to pay what the hospital charges, and the patient is on the hook for the balance.
The Texas Department of Insurance’s mediation program can intervene when Texans complain about an unexpected bill—often after an emergency in which a patient is rushed for treatment at an out-of-network hospital.
Historically, the state program had many restrictions that left few consumers eligible for help. But the Texas Legislature expanded it in 2017.
Since then, more patients have been filing complaints. In 2014, the department was asked to mediate 686 medical bills. During the 2018 fiscal year, however, it received 4,445 bills, more than double the 2,063 bills received in 2017.
Even after the changes, the mediation program could be a lot more robust and is likely addressing only a fraction of these problematic bills, consumer advocates say.
The Pivotal Role of Payers in Improving Health Equity, Maternal Health Care in the US
March 26th 2024A presentation at the Greater Philadelphia Business Coalition on Health's 2024 Women’s Health Summit discussed how payers, including employers and public entities, can strategically influence health care purchasing to prioritize maternal health and equity.
Read More
Navigating Health Literacy, Social Determinants, and Discrimination in National Health Plans
February 13th 2024On this episode of Managed Care Cast, we're talking with the authors of a study published in the February 2024 issue of The American Journal of Managed Care® about their findings on how health plans can screen for health literacy, social determinants of health, and perceived health care discrimination.
Listen
Oncology Onward: A Conversation With Penn Medicine's Dr Justin Bekelman
December 19th 2023Justin Bekelman, MD, director of the Penn Center for Cancer Care Innovation, sat with our hosts Emeline Aviki, MD, MBA, and Stephen Schleicher, MD, MBA, for our final episode of 2023 to discuss the importance of collaboration between academic medicine and community oncology and testing innovative cancer care delivery in these settings.
Listen
QCCA, NCCA Merge to Form ONCare Among Independent Oncology Practices
February 29th 2024ONCare Alliance will be led by 2 of the leading women in community oncology, cochairs Barbara McAneny, MD, of the New Mexico Cancer Center, and Sibel Blau, MD, of Northwest Medical Specialties, PLLC, of Puyallup, Washington.
Read More