Charlotte Observer/Raleigh News & Observer: Patients Pay More for Tests and Procedures if Their Physician is Employed By a Hospital

A joint article from the Charlotte Observer/The Raleigh News & Observer, Doctors join hospitals, and prices soar, found that “North Carolina patients pay more for many tests and procedures if their physician is employed by a hospital.”

AHIP spokesperson Robert Zirkelbach was quoted in the article, saying “Prices are increasing, often for no other reason than the sign on the door changed.”

According to the American College of Cardiology, the number of doctors working for hospitals has more than tripled in the past five years. This trend is evident in North Carolina, where “…in the Triangle, about 90 percent of cardiologists work for hospitals, which can charge more for procedures than private practices.” A health care recruiting company cited in the article expects that 75 percent of all doctors will be employed by hospitals within two years.

To Zirkelbach’s point, a primary criticism of provider consolidation is that it allows hospitals to charge patients more for identical procedures. How much more? “One example: For a common echocardiogram procedure, Duke Hospital submitted 4,879 claims to Medicare in 2010, up 68 percent from the year before. Medicare allows $471 for outpatient echocardiograms, more than twice the $200 allowed for those performed in physician offices.”

Robert Berenson, an analyst with the Urban Institute’s  Health Policy Center, has concerns about the trend toward consolidation. “‘That’s taking advantage of the payers and really harming consumers,’ said Berenson, who previously served as a commissioner of MedPAC, which advises Congress on Medicare policy. ‘It is not promoting more efficient care.’”

To raise awareness of the issue, AHIP has developed an infographic on the impact of provider consolidation on prices:

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