LAKEWOOD, Colo. — Commercial insurance plans pay Colorado hospitals, on average, almost three times what Medicare pays for the same care. A hospital in Fort Morgan charges nearly eight times more than Medicare reimbursements. That's according to a new Hospital Value report on pricing and performance.
Bob Smith, executive director at the Colorado Business Group on Health, one of the groups behind the report, said current incentives in place have boosted stock values, but the marketplace is not working for firefighters and school districts who have been hit with rising costs.
"Colorado hospital net profit is four to five times the average hospital in the country. Insurers have seen their earnings per share go up anywhere from 300% to 1,000% in the last decade,” Smith said. “The system works really well for them."
The report found performance outcomes vary as much between as within hospitals, and Smith said there seems to be no reliable correlation between price and quality of care.
Hospital administrators have long argued higher costs are passed along to commercial plans to help make up for what they believe are insufficient Medicare and Medicaid reimbursements. Hospitals also charge more to cover the costs of treating people who can't afford to pay.
Smith pointed to annual reports by an independent commission to Congress showing efficient hospitals can break even on Medicare. But, he said excessive payments in the commercial market negate the need for hospitals to be efficient and control costs.
Smith said the impact on consumers is significant. Twelve years ago, Jefferson County teachers earning $50,000 a year paid less than 5% of their salary for health care.
"Today, if you make $50,000 as a teacher - which is still well above the starting teacher salary - you have to pay a quarter of your salary for family health care,” he said.
Smith said the report's recommendations are in sync with Gov. Jared Polis' plans for reducing health-care costs, and include efficiencies such as getting hospitals to join forces for high-cost care, and getting insurers to adopt uniform payment systems. The report was released July 23 by Smith's group and the Colorado Consumer Health Initiative.
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Lawmakers in Olympia this session moved to add more protections for consumers against predatory loans.
Washington state lawmakers passed Senate Bill 6025 unanimously in both chambers, closing a loophole companies were using to evade caps on the amount of interest charged on loans.
Sam Leonard, an attorney in Seattle, said tech companies providing financial services such as loans would charter out of state banks, especially in Utah, where lenders can charge unlimited interest rates.
"These fintech lenders a lot of times will charge 150, 200% interest on relatively small dollar loans, $3,000, $5,000 and the like," Leonard explained.
Washington state has a set of protections called the Consumer Loan Act to shield people from predatory loans. Leonard said capping interest rates at the federal level would help people across the country.
However, he emphasized the bill goes a long way to increase protections for Washingtonians.
"Not a lot of states at this time have passed similar legislation," Leonard pointed out. "Washington is out in front of the curve with regard to protecting low-income Washingtonians or other Washingtonians that might enter into these predatory loan products."
Leonard added the issue with predatory loans is they keep people in continuous debt cycles.
"Loan products like these essentially strip low-income individuals' ability to improve their economic situation," Leonard noted.
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While there's snow in the immediate forecast, the spring storm season has arrived in Minnesota and state officials said with complaints related to homeowner insurance claims on the rise, it is important to monitor changes in policies.
The Minnesota Commerce Department said complaints from policyholders, largely stemming from their claims being denied, have more than doubled since 2020.
Julia Dreier, deputy commissioner of insurance for the Minnesota Department of Commerce, said under a changing climate, the nation is seeing plenty of extreme weather events resulting in wind and hail damage, and insurance companies are adjusting to what's happening.
"Insurance costs are going to increase," Dreier pointed out. "We do want to make sure that Minnesotans are prepared."
As some carriers narrow what is covered or require higher deductibles, Dreier urged consumers to carefully review their policy when it is up for renewal, to avoid surprises when they have to file a claim. The department acknowledged changes can slip under the radar when consumers rely on paperless statements sent via email, or with busy schedules preventing them from reading all the fine print in documents they receive.
The department emphasized it is a complicated process in getting complaints resolved, noting some can be partially reversed in favor of the homeowner. Dreier noted they work closely with the industry to make sure a company's actions are within the letter of the law.
"One of our jobs is to make sure that insurance companies aren't doing something unethical when they're submitting their policy forms to us and their rates to us for review," Dreier added.
The department does have a new video on its YouTube channel, which offers more details on how to better prepare yourself ahead of any future claims, including knowing whether your policy offers flood protection and assessing the value of items in your home.
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Wisconsin has announced a big development in trying to establish more digital equity around the state.
Gov. Tony Evers and the Public Service Commission say Wisconsin's blueprint for digital equity has been accepted by the National Telecommunications and Information Administration.
That means the state is eligible for up to $30 million to implement its approach over the next five years.
Martha Cranley - state director for AARP Wisconsin - called it a robust plan, noting that older populations continue to face challenges in being connected to the digital world.
"We know that at least 15% of people 50-plus in Wisconsin are not connected," said Cranley, "either because the wires simply don't come to their house, or they don't have a device, or they don't know how to use it."
Cranley said the lack of connection is especially concerning in rural areas across northern Wisconsin, where aging communities have limited resources.
Stakeholders also note an infusion of new aid is helpful with the federal government's Affordable Connectivity Program - which provides discounts on monthly internet bills for eligible households - in danger of running out of money.
Cranley said the state's plan came together following extensive public outreach, in which her organization helped convey the need for improved internet access for those 50 and older.
"They certainly heard from older people about how important this is to connect to their doctor," said Cranley, "and to connect to government services, and frankly, find employment."
Overall, Evers says the plan's federal approval means more than 410,000 homes and businesses will be better positioned to be connected to new or improved high-speed internet service.
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