New Study Highlights Problem Of Surprise Medical Bills For Consumers

By Consumers for Quality Care, on August 1, 2017

In another chapter of an ongoing trend, consumers across the country have been facing steep medical bills after hospital visits they thought were in their insurance network.

One California woman, Debra Brown, was shocked to get $500 out-of-network hospital bill from a doctor who she said never identified himself and only briefly touched her injured ankle that sent her to the hospital. The New York Times reports:

After slipping on some wet leaves outside her house in Crescent City, Calif., in February, Debra Brown, a 60-year-old county accounting clerk, wound up at Sutter Coast Hospital. She is paying off her deductible, but her insurer covered most of her remaining hospital bill. She was shocked to get an additional bill from a doctor who she said never identified himself and only briefly touched her broken ankle. That physician worked for EmCare. Her portion of the bill is more than $500.

“Now I’m going to have to pay this bill off, and I can’t afford to see a doctor about my high blood pressure medication,” Ms. Brown said. “This is insane, and it’s greedy.”

A new study by researchers at Yale has found that the number of consumers facing out-of-network bills, often called surprise bills, heavily increases when a company called EmCare enters a hospital.

The doctor who treated Brown worked for EmCare. The Yale study shows that when EmCare enters a hospital’s operations, patients like Brown end up at the wrong end of large hospital bills.

One of they authors of the Yale study described the strategy as a “kind of ambushing of patients.”

Fiona Scott Morton, a professor at the Yale School of Management and a co-author of the paper, described the strategy as a “kind of ambushing of patients.” A patient who goes to the emergency room can look for a hospital that takes her insurance, but she almost never gets to choose the doctor who treats her.

Unexpected medical bills can have a huge impact on consumers. Unpaid medical bills recently surpassed credit card debt as the number one cause of bankruptcy.