September 2019 Volume 21 Issue 9
Providing Current Information on

Health Insurance Industry Issues and Legislation

Surprise Billing - A Few Bad Apples
The chance of receiving a surprise hospital bill is more than 9 out of 10 in 15% of
the 3300 hospitals surveyed for a recent study published in the latest edition of
JAMA. The percent is even higher, 23% of hospitals, for facility emergency room
visits. Emergency Department visits resulting in a surprise bill increase from by
more than 25%, while surprise bill for inpatient admission increased by almost 60%.
Taking the Sting Out of Surprise Bills
Costly surprise bills from out-of-network providers for emergency room visits and
hospital admissions can be painful for everyone. But they don't have to be. Utilizing
a combination of technology and tenacity a skilled cost containment company,
like HHC Group, will find a way to cut surprise bills and other out-of-network bills
down to size. A company like HHC Group will have its skilled negotiators convince
providers to accept an appropriate amount for their services, will access discounts
from its PPO partners and will scrutinize the bills to identify costly overcharges and
errors and take the sting out of those surprise bills.
Healthcare Cost Trends Not Looking Good
The healthcare cost trend continues to outpace general inflation and is predicted
to do so for years to come according to pwc's latest medical cost trend report. They
predict a 6% increase, slightly higher than the last 2 years and about 3 times the
rate of inflation overall. Drug spending will continue to rise with the introduction
of biosimilars, branded generic and costly new treatments. According to the
report, employers are employing a variety of strategies to try to control their rising
healthcare spend.
Cancer Tops List of Self-Insureds High Cost Claims
More than one third of Americans will be diagnosed with cancer at some point in their
lives. Many cases require injectable drug therapies and the lengthy treatment regimens.
As a result, cancer tops the list of high-cost claims for self-insured employers. Based on
one stop-loss carrier's experience, cancers accounted for over a quarter of total stop-
loss reimbursements in the last 3 years. Targeted therapies and immunotherapies hold
great promise for treating cancer in the future, but for now Cancer remains the most
costly disease for self-insureds and fully insured alike.
Three Star Preferred Provider Program Additions
Invaitae Corporation
San Francisco, CA 9401

Access Endocrinology LLC
Rockledge, FL 32955

Martinez Urgent Care
Martinez, GA 30907

Northeast Ohio Vascular
Willoughby, OH 44094

Southern Bone and Joint
Hattiesburg, MS 39401

South Shore Anesthesia Associates, LLC
East Weymouth, MA 02189

Wayne S. Berberian, M.D.
Maywood, NJ 07607