As lawmakers discuss the rising cost of healthcare, the role corporate insurance companies play in driving higher costs and denying patients’ care while banking record profits should be front and center.
- Recent investigations shed light on how corporate health insurance companies are putting profits ahead of patients and their bottom lines ahead of people’s lives. Investigative reports show that corporate insurers “routinely reject claims for necessary care” in order to maximize their own profits.
- Nearly 90 percent of physicians say they have personally seen burdensome policies from corporate insurance companies, like excessive or inappropriate prior authorization requirements, which negatively affect patients’ clinical outcomes.
- Nearly 20 percent say they have seen corporate insurance company policies cause a life-threatening event.
- As The Washington Post reports, the prior authorization “process can be confusing and lengthy. Denials are common and appeals are often difficult to navigate. Doctors say some people end up dying while waiting for an insurer’s permission for care.”
- When corporate insurers force caregivers to wade through red tape, it diverts health professionals’ time and attention away from caring for patients who need help.
- Corporate insurers’ mass denials of coverage aren’t just unfair to patients. When corporate insurers deny care, the burden falls on hospitals and health systems already facing financial headwinds.
- The cost burden from corporate insurance denials exploded by 67 percent in 2022.
- Half of all hospitals report having more than $100 million in outstanding claims that are older than six months.
- One recent study finds 40 percent of hospitals report losing more than a half million dollars every year to denied claims.
- At the same time their abusive practices threaten access to care at the hospitals patients count on, corporate insurers have spent billions of dollars buying up physician practices to exert even more control over Americans’ care.
- Corporate insurers have leveraged their market power to raise the rates that hospitals pay for services, driving up patient costs.
- Today, a single corporate insurance company controls 10 percent of all physicians nationwide.
- Meanwhile, a recent report by the Medicare Payment Advisory Commission (MedPAC) reveals that corporate insurance companies are projected to take in more than $88 billion in overpayments from the Medicare Advantage program in 2024.
- The news comes amid growing, bipartisan concerns about the abusive practices of corporate insurers toward Medicare patients, including denials of care.
Given the facts, it’s no wonder a recent poll finds that voters are concerned about corporate insurers’ role in driving higher healthcare costs and delaying and denying patients’ care.
Yet today, these same corporate insurers are pushing Congress to enact harmful Medicare cuts that would jeopardize access to crucial health services that only hospitals provide and put patients at even greater risk.
The bottom line: cutting patient access to hospital care is not a solution to the challenges of healthcare costs – and if Washington politicians side with corporate insurers to cut Medicare, patients will pay the price.