A new study confirmed what anyone in Wyoming who’s opened a medical bill already knows too well: The cost of health care here is breathtakingly high.
The study showed that Equality State hospitals charged private insurance plans more than three times what Medicare would pay for the same care. That disparity was the second highest among the 25 states that were part of the study, falling behind only Indiana.
The details are just as concerning. Only two of the 14 hospitals surveyed – Weston County Health Services and Washakie Medical Center – had charges within 200 percent of Medicare. On the other end of the spectrum, SageWest Health Care in Fremont County charged private insurance more than eight times what the facility was paid by Medicare, while Evanston Regional charged at rates nearly six times as high.
The state’s two largest hospitals, Cheyenne Regional and Wyoming Medical Center, charged insurers 480 and 392 percent of Medicare respectively in 2017.
To be clear, these figures show how much hospitals charge insurance companies, not individual patients. But patients are still dinged by high prices, one way or another. If hospitals are charging insurance companies more, Wyoming businesses – which are responsible for covering many of those people with private insurance, take a hit in their ledger books. Employers, in turn, often respond by passing those increased costs on to their workers in the form of higher premiums and co-pays.
In other words, high prices affect everyone. And that’s what makes this a bipartisan issue, and one that must be addressed. There are roles for both the hospital industry and government to play.
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The hospitals themselves have a vested interest in being part of the solution. After all, they will suffer if patients flee to facilities in Colorado, Utah or Montana because of cost. The association that represents Wyoming hospitals has taken issue with the study, criticizing the decision to use old data and Medicare as the baseline. But while you could quibble with the details, this study reinforces something nobody disputes: prices are high. The best thing hospitals could do is help figure out why those prices are so expensive – and then devise a plan to do something about it.
For example, the Wyoming Medical Center board recently unveiled the broad outlines of a strategic plan. That plan focuses on things like growing local access to high-quality care. We hope the plan will address high prices, given that high prices can inhibit access to medical care.
But hospitals should not be expected to fix this problem alone. Lawmakers also have a role to play. They’re repeatedly rejected federal approaches to improving the accessibility and cost of health care. The stated reasoning is often the same: Wyoming needs its own solution to address its unique challenges.
But so far, lawmakers have done little more than talk and ask for studies that they fail to act upon. A new study is in the works, which could offer answers into why prices here are so high. But for that study to be useful, legislators will need to work with others, like hospitals and insurance companies to do something productive with it. Up until now, they’ve shown little appetite for taking on one of the state’s biggest challenges. This is a big opportunity lawmakers need to take, working with the hospitals willing to examine the problems in depth and take action to solve this very real problem.
Because in a time of polarization, the need for a health care system that’s affordable is one of the few things that most Wyomingites agree on. The time is now. Neither party can solve much by themselves. Hospitals and our state leaders owe it to the residents here to work together to finally do something about it.