GUEST ESSAY: Site-Neutral hospital billing reforms will help save patients, taxpayers money
By MIA MCCORD
As the executive director of Texans for Affordable Health Care, I have a front-row seat to our current health care system’s intricacies and the challenges that are perpetuating exorbitant medical costs. Beyond the boardroom discussions and policy debates, it's everyday Texans — families, small businesses and the broader economy — who bear this burden.
Hospital consolidation is partly to blame. Across America, the ten largest health care systems collectively own 25 percent of the market. Medical costs rise as higher fees are assigned to medical care in newly owned facilities. The cost of identical medical services can increase by nearly 40 percent based on the new ownership of the building.
For families across the Lone Star State, these out-of-control costs cause difficult choices, with 40 percent of people forced to delay essential care due to fear of medical debt. This financial strain breeds distrust in the system, with 87 percent of Texans expressing concern about hospital consolidation.
The impact of this problem extends far beyond individual patients. It impacts small businesses directly, where the weight of soaring health costs is particularly pronounced. In a nation where over 61 million Americans are employed by small businesses, these concerns are not just business obstacles but personal challenges for employees and their families who depend on these employers for support.
Shifting focus to broader repercussions of high health costs, the strain on the Medicare program overburdens an already inflated federal health care budget. Our country stands on the precipice of record national debt levels while navigating an economy marked by high inflation and growing interest rates. The ramifications are clear: our nation is on shaky ground, and corrective action is imperative.
Currently, Medicare pays more for services provided in hospital outpatient departments — HOPDs — which are owned by a hospital but are not located on the hospital’s main campus.
While Congress passed legislation applying physician payment rates to HOPDs outside a hospital’s campus, special rules allowed certain HOPDs to continue charging patients higher rates, maintaining an incentive for hospitals to acquire independent physician practices.
This is precisely why the TAHC advocates for legislative measures like the Site-based Invoicing and Transparency Enhancement Act in the U.S. Senate and the Facilitating Accountability in Reimbursements Act in the U.S. House of Representatives. These initiatives would bring financial relief to patients, businesses and the national budget by targeting the root causes of escalating health expenses.
The core of these legislative proposals is expanding site-neutral payments, thereby stopping the practices of corporate hospitals from inflating medical bills based on facility ownership. This legislation could save Americans $471 billion over the next decade and reduce the federal budget by as much as $279 billion. These are not just figures on paper; they are resources that can be redirected into the pockets of everyday Americans and invested in other critical government programs, easing financial hardships for citizens and the federal government.
The fight for affordable health care is not a niche concern. It is an issue that touches every aspect of our society, from the kitchen tables of Texas families to the desks of small businesses to the chambers of federal governance. This is why, as a representative of TAHC and fellow Texan, I strongly urge Senators Ted Cruz and John Cornyn as well as Representative Lloyd Doggett to work together on this bipartisan effort.
We're not asking for a handout. We're claiming what's rightfully ours – a voice in the conversation about our health and wallets. This isn't about politics. It's about people. It's about Texans who've had enough of health care roulette. The table is set — let's pull up a chair and make things right with hospital billing.
Mia McCord is the Executive Director of Texans for Affordable Health Care. She lives in Leander, Texas.