November 1, 2022 – Private commercial health insurance is a central component to the health insurance system in the United States, serving as the dominant source of health coverage for most Americans and employers. In addition to the prevalence of commercial health plans, Medicare and Medicaid programs often rely on private health insurance plans to administer their health benefits.
The American Hospital Association (AHA) recently released a report – “Commercial Health Plans’ Policies Compromise Patient Safety and Raise Costs” – on the current state of the private commercial health insurance system. In this report, the AHA identifies the areas with the most opportunity for improvement.
Perhaps the most alarming revelation the AHA report discovered here is that health insurance policies dictate the bigger decisions regarding the care of a patient. The report says, “Some commercial health insurers have implemented policies that add billions of dollars in added unnecessary administrative costs to the healthcare system while compromising patient care. Commercial health plan abuses must be addressed to protect patient’s health and ensure that medical professionals, not the insurance industry, are making the key decisions in patient care.”
The AHA said that commercial insurance policies, like utilization management tools and prior authorization requirements, create significant barriers to patient care and unnecessarily spike administrative costs – while at the same time commercial insurance premiums have been steadily growing above the rate of inflation. Prices are up by 47% in the last 11 years.
Learn more in October’s issue of Repertoire Magazine.