An inaugural report of the New York Health Department aimed at Retraction of high sky hospitals invoice patients At gaping holes because Big Apple’s largest public insurer refuses to submit files, officials said.
The 263 pages report Friday quietly through the The Agency’s new office for health care liability said hospitals prices are extremely incoherent. The study focused on payments made through the city’s health care provider, Anthem Blue Cross, and not private sector insurance plans.
The GHI Complex Background Plan of the city via Anthem paid an average of $ 45,150 for hospital services during the last financial year in the 10 best hospital systems in New York, according to the report.
The highest prices for complete hospital treatment were at New York-Presbyterian ($ 92,727) and Montefiore Medical Center ($ 83,573), while Stony Brook University Hospital was the lowest ($ 36,876).
The report noted that the City had spent $ 3.3 billion paying for employee hospital care during the fiscal year ending on June 30, and half went to three hospital systems: Northwell Health ($ 759 million), New York-Presbyterian ($ 485 million) and Nyu Langone Health ($ 443 million).
New York-Presbyterian had the highest prices for 11 of the 12 hospital procedures analyzed and 14 of the 27 ambulatory procedures, according to the report.
The prices of hospital systems widely varied, from $ 940 to $ 12,000 for a colonoscopy and from $ 7,000 to $ 58,000 for a restoration of Cesarean section.
And the city now spends more in hospital ambulatory care than for hospitalized patients.
The report quoted Anthem – that the city pays $ 3 billion a year to provide insurance to around 900,000 employees – for refusing to provide the OHA with the full health care costs in hospitals and other data it needs to determine if these prices are justified.
Anthem said that the publication of some of the data on prices would violate privacy agreements with hospitals prior to a 2021 federal rule forcing hospitals to disclose their prices to the public.
However, advisor Julie Menin (D-Manhattan), who sponsored legislation creating the first health care monitoring office in 2023, does not buy it.
“It is a slap in front of the city of New York when the federal rules require that hospital prices be made public, but the anthem will not comply with the city law due to” pre-existing agreements, “she said. “This cat and mouse game from the health care industry costs billions of cities, and we need total transparency now.”
“It’s so painful to see these prices,” added Menin. “It’s extremely high and that’s why we need prices transparency. Why should New York pay so much for health care? It’s disgusting and unbearable. “
The city’s health care insurance contract is up later this year, and the city “must require a complete disclosure of the prices” to the one who obtains it, “said Menin. Anthem is one of the tenderers for the New Deal.
The post Two years ago reported On the analyzes of 32BJ Seiu, the union of employees of the city’s construction services, showing that the Big Apple could allow taxpayers to save up to $ 2 billion per year by checking exactly how much municipal workers pay for care in various hospitals and making recommendations on the means of reducing prices.
Manny Pastreich, president of the 32BJ, said that his union had pushed hard to create the OHA, but added that it is regrettable that the “inaugural report is more remarkable for what is missing”.
“It is clear that hospitals and insurers are still having their influence to share certain data that the city needs to reverse the trend in exorbitant health care costs,” he said.
The OHA was largely created to provide greater transparency to patients on the costs of medical procedures in a private hospital compared to medical facilities managed by the city, because it has the power to publicly release the prices of the hospital throughout the city. It works with a budget of $ 2 million and 15 staff.
“New York Hospitals and Hospitals of New York must remove arbitrary obstacles to access to data that would otherwise support the transparent and equitable prices of medical services,” said Henry Garrido, Executive Director of the District Council 37, the largest municipal union of the city.
“We must use each tool at our disposal to fight against these unfair practices, in particular by ensuring that the office of health care liability is adequately endowed to achieve its main objective to fight against the prices of disparities which exploit the vulnerabilities of New Yorkers in care.”
Anthem Reps did not immediately send messages.