Health care is more than a normal transaction. It is often a matter of life and death. The lives of Texans should never be used as a bargaining chip in a ruthless game of hardball. Sadly, this is exactly what is occurring across our state.
As high-stakes contract renewal negotiations between health insurance companies and hospitals pick up, Texans are seeing alarming headlines about the uncertain future of their health care coverage.
This is part of a growing national trend. The first half of 2023 saw 41 contract disputes covered in the media, nearly three times the 15 reported in the same period last year, according to analysis by FTI Consulting. The study also found that nearly a third of the public disputes failed to be resolved, leaving hundreds of thousands of patients out of network with their providers.
Why is this happening? To further strengthen their bargaining position, insurers will sometimes threaten to drop a hospital’s facilities and providers from their network.
This cycle of putting the well-being of Texans in the crossfire will repeat until we introduce more competition in the health insurance marketplace. That’s the only way to put a real check on the disproportionate bargaining power of the national insurance carriers that control most Texans’ access to health care.
For many large health insurers, these tactics have become business as usual. But for patients and employers, who depend on predictability and reliability in their health care coverage, these disruptions can have devastating consequences.
Many hospitals in Texas and across the country are struggling to hold on, too, with the industry posting its worst financial year in 2022 since the start of the pandemic, and 2023 is on track to be even worse. Rising costs are quickly borne by employers and their employees. A 2022 report found that Texans spent more than 14.2% of the median income on health insurance premiums and deductibles, a steady increase since 2010.
Instead of searching for solutions, the nation’s largest insurers continue to post record profits as they leverage their market power to squeeze providers. The consequences are felt throughout the health care system. The recent nurses strike at Ascension Seton Medical Center — the largest nurses strike in Texas history — is just one example of how disputes over dwindling resources lead to health care chaos.
According to the American Medical Association, health insurance market concentration has worsened in recent years due to industry consolidations. Research shows the lack of competition leads to higher prices and worse health outcomes.
A more diverse marketplace could help stop the brinkmanship that’s harming patients, while increasing quality and lowering costs. Instead of pitting hospital systems against each other, we should align hospitals and providers that offer the highest quality care. This focus on long-term partnerships ensures that we invest in the success of our hospital partners, fostering a culture of trust and shared goals.
More innovative models in the health care industry would offer increased opportunities to implement value-based care strategies that lead to better patient outcomes and cost savings. By encouraging the entry of new players and fostering a competitive environment, we can drive advancements in health care delivery and ultimately enhance patients’ well-being.
Texans deserve to be in control, not held hostage, when it comes to their health care. By increasing competition and allowing innovation to thrive, we can make sure they are.
Chris Wilson is the chief revenue officer of Healthcare Highways.